Verification of tetanus vaccination status of children admitted for animal bites in a pediatric emergency department.

Abstract

Animal bites are high-risk wounds for tetanus. Our objective was to verify that children admitted to the pediatric emergency department (PED) for bites had reliable management of the risk of tetanus. This retrospective descriptive study was conducted at Lille University Hospital between 2015 and 2020. Patients under the age of 16 years admitted to the PED for bite wounds were included. The rate of appropriate management was calculated using a strict or pragmatic definition, based on the presentation or not of the health booklet. Among 336 patients included (median age 5 years, 47% boys, 69% wounds on the face; 90% of bites by dogs), 86% had their vaccination status mentioned in the medical observation, more often during daytime hours (p = .02) and by the medical team (as compared to the surgical team; p < 10^-3). 90% of these were declared up-to-date for their tetanus vaccination. Management was deemed appropriate in 16% according to the strict definition and in 80% using the pragmatic definition. 28 patients were not up to date (10%). Eight of these 28 (29%) had an appropriate management. The management of a bite wound must be systematized with verification of tetanus vaccination status to avoid preventable disasters.