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Inicio Medicina Clínica (English Edition) Use of the tetanus quick stick (TQS) test in the emergency services
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Vol. 153. Issue 10.
Pages 394-401 (November 2019)
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Vol. 153. Issue 10.
Pages 394-401 (November 2019)
Review
Use of the tetanus quick stick (TQS) test in the emergency services
Uso del test rápido de tétanos (TQS) en los servicios de urgencias
Tamara Martín-Casqueroa, Esther Ruescas-Escolanoa, Jose Tuellsb,
Corresponding author
tuells@ua.es

Corresponding author.
a Servicio de Urgencias, Hospital Universitario del Vinalopó, Elche, Spain
b Cátedra Balmis de Vacunología, Universidad de Alicante, Alicante, Spain
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Abstract

Standard procedure when treating tetanigenic risk wounds (TRW) in an emergency room setting, usually includes administering a dose of gamma-globulin or/and a tetanus vaccine.

The rapid detection test (Tetanus Quick Stick TQS) can better the current procedure of detecting people who are not immunized. Our objective was to review and analyse the validity of the TQS test, and determine the cost-benefit with the data available.

We searched the following data bases for information: WoS, PubMed, EMBASE & SCOPUS. After reviewing articles and applying inclusion/exclusion criteria, we included 20 articles mostly European and written by Emergency room services. Sensitivity ranged from 55% to 100%, specificity from 66.6% to 100%, PPV: 81.1% to 100%, NPV: 42.9% to 100%. Most of the tests supported the cost-benefit analysis of the TQS test. We determined that in emergency room situations, it would be beneficial to use the TQS test, and a example of good clinical practice.

Keywords:
Tetanus
Tetanus quick stick (TQS)
Emergency service
Diagnostic test
Cost-benefit analysis
Resumen

La atención a las heridas de riesgo tetanígeno (HRT) en los servicios de urgencias suele incluir la administración de gammaglobulina y/o vacuna antitetánica.

La prueba de detección rápida de anticuerpos frente a tétanos (Tetanus Quick Stick, TQS) podría mejorar la práctica clínica habitual al identificar a las personas no inmunizadas. Nuestro objetivo es analizar la validez de la prueba diagnóstica TQS y su coste-beneficio según la literatura disponible.

Realizamos una búsqueda en las bases de datos WoS, PubMed, EMBASE y SCOPUS. Tras aplicar criterios de inclusión y exclusión, se recuperaron 20 artículos, la mayoría europeos y redactados por servicios de Urgencias. El rango de los test de sensibilidad oscila entre 55–100%, de especificidad entre 66,6–100%, VPP: 81,1–100% y VPN: 42,9–100%. La mayoría de estudios avalan el coste-beneficio de la aplicación del TQS. Creemos que el uso del TQS en Urgencias sería recomendable y un ejemplo de buena práctica clínica.

Palabras clave:
Tétanos
Prueba rápida de tétanos
Servicios de urgencias
Pruebas diagnósticas
Coste-beneficio

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