Wilderness Medicine, First Aid, and Outdoor Skills

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Search and Rescue
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US Army First Aid Manual
Fundamental Criteria for First Aid
Basic Measures for First Aid
First Aid for Special Wounds
First Aid for Fractures
First Aid for Climatic Injuries
First Aid for Bites and Stings
First Aid in Toxic Environments
First Aid for Psychological Reactions
Appendix A: First Aid Case and Kits, Dressings, and Bandages
Appendix B: Rescue and Transportation Procedures
Appendix C: Common Problems/Conditions
Appendix D: Digital Pressure
Appendix E: Decontamination Procedures
Appendix F: Glossary

Table of Contents


If you have reviewed many of the topics on Survive Outdoors, you would find that with many injuries we do recommend a tetanus update. We feel it is our responsibility to give you information on what Tetanus is and why it is so important to have the immunization. Clostridium tetani is a bacteria that can survive for many years in various areas on dirt, nails, wood and a variety of substances that we become involved in when camping, hunting, fishing, and any outdoor activity. Clostridium tetani, which can cause severe illness and death, has been referred to as lockjaw. This is due to individuals that do get this organism and have not had tetanus updates. Severe muscle spasms can occur throughout the body and especially the jaw area, hence the term lockjaw. Apparently, there are less than 40 cases of tetanus reported every year in the United States. Usually this involves individuals that are greater than 55 or 60 years old, mostly because they have not updated their vaccination of tetanus. It is seen much more frequently in rural areas, and poverty areas where there are poor immunization programs. The infection usually follows a local injury such as a puncture wound, scratch, or laceration. The wound is present in only about 20% of the patients. The reason for this is that the incubation period of tetanus is anywhere from one day to several months, with an average of about eight days. Many times the wound will heal, but the bacteria has been instilled into the wound area. Higher risk is deep wounds as opposed to superficial wounds.

Tetanus Symptoms

As previously stated, the incubation period from the time of the wound to the time of the symptoms is anywhere from a day to several months, with an average of about eight to nine days. Initially, individuals are very tired, irritable, have headaches, neck stiffness, and difficulty swallowing. Then comes the muscle rigidity and spasm, which you will have sustained contractions of muscles, specifically facial and jaw muscles, hence the term “lock jaw”. The overall mortality rate is around 30%. In individuals over 60 years of age, it jumps to 50%.

Tetanus Treatment

Treatment of Clostridium tetani is beyond the scope of this website, and we are going to focus more on prevention.

Tetanus Shot

Currently the reccomendations for non-tetanus prone wounds, lacerations, punctures and small abrasions if the individual has not had a tetanus update in the past ten years, they should get an update. If it is a tetanus prone wound, such as a very deep wound from working in a horse barn, for example, a deep puncture wound from a nail. These individuals would get a tetanus update plus a tetanus immune globulin, especially if their tetanus has been greater than five years since their last dose.

Tetanus Shot Side Effects

This examiner has only seen maybe two or three local side effects related to a tetanus injection from the thousands and thousands of tetanus injections this author has seen in the last 20-25 years. Local reactions are redness at the injection site, tenderness mostly the next day of the arm area. Rarely will the redness be larger than a silver dollar at the site. That is the extent of the tetanus shot side effects. There is more fear over the injections and shots themselves in general. The benefits of having tetanus shot far outweigh the risks of any local side effects. Survive Outdoors strongly recommends tetanus updates for any individual who is heavily involved in the outdoors, as well as all individuals.

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