Pedemy All toolsAnswer one question at a time. The plan gives tetanus, rabies and antibiotic steps with weight-based doses. Tap any earlier answer to change it.
This tool helps clinicians manage wounds and animal or human bites in children. It covers tetanus vaccine and tetanus immune globulin (TIG) based on wound type and vaccine history, rabies post-exposure prophylaxis based on the animal, and antibiotic prophylaxis for bites, with weight-based doses.
For tetanus, clean minor wounds need vaccine if the child has fewer than 3 doses or an unknown history, or if the last dose was 10 or more years ago. Dirty or major wounds, including all bites, need vaccine if the series is incomplete or the last dose was 5 or more years ago. TIG 250 units is added for dirty wounds when the series is incomplete or the child has HIV or severe immunodeficiency, and is never needed for clean minor wounds. DTaP is used under 7 years and Tdap from 7 years. For rabies, bites from bats, wild carnivores, or a dog, cat or ferret that cannot be observed lead to prophylaxis now. A healthy dog, cat or ferret can be observed for 10 days instead.
Rabies prophylaxis is HRIG 20 IU/kg plus vaccine on days 0, 3, 7 and 14, or vaccine on days 0 and 3 only for previously vaccinated children. High-risk bites get amoxicillin-clavulanate. Sources include CDC tetanus and rabies guidance (September 2026), ACIP 2010, IDSA 2014 and the AAP Red Book 2024–2027.
TIG 250 units IM is given for dirty or major wounds, including bites, when the child is unvaccinated, has an unknown history or fewer than 3 doses, or has HIV or severe immunodeficiency. TIG is never indicated for clean, minor wounds.
For a child not previously vaccinated: HRIG 20 IU/kg on day 0, infiltrated around the wound if possible, plus 1 mL rabies vaccine IM on days 0, 3, 7 and 14. Immunocompromised children add a day 28 dose. Previously vaccinated children get vaccine on days 0 and 3 only, with no HRIG.
The tool lists cat bites, deep punctures, hand, face, genital or near-joint wounds, crush injuries, wounds needing closure, delay over 8 hours, immunocompromise or asplenia, and all human bites that break the skin. Amoxicillin-clavulanate 45 mg/kg/day for 3–5 days is the first choice.
Free to use on clinic, school, blog or hospital pages. Copy this code into your page: