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To the Editor:—
The report by Dr. Eade, entitled "The Unreliability of Tetanus Antitoxin Skin Tests After Injury" (JAMA180:972 [June 16] 1962), emphasizes that after severe trauma the reduced skin blood flow may be sufficient to produce a false negative, intradermal reaction to tetanus antitoxin (TAT). He states that "the usual practice after injury is to give a skin test, observe for 20 to 30 minutes, and then give TAT." Correct practice consists of obtaining a complete history of allergic conditions, especially sensitivity to horse dander or serum, and testing with normal horse serum by both the intradermal and conjunctival methods. A positive conjunctival reaction, although rarer than a positive intradermal reaction, is much more significant, and is a contraindication to administering the serum. The exact technique for performing these tests and the procedure for administration of TAT, based on the results of the history and the testing,
Kaufman RE. Tetanus Antitoxin Skin Tests. JAMA. 1962;182(3):315. doi:10.1001/jama.1962.03050420091029
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