Urgent: Cheapest wound care/tetanus vax near Howell, NJ?

April 26, 2013 4:50 PM

Trying to coordinate help for a friend. She stepped on a nail, doesn't have current Tetanus vax. She needs to have the wound thoroughly cleaned and get a tetanus vax. Just the shot at Walgreen's would be $200 - she needs something cheaper (no insurance).

They're in Howell, NJ. They can drive a ways if the savings will be significant. The vaccination is obviously important, but I'd also like to get her to a place that will do the wound care, too.

Best would be open tonight, but places she can go first thing in the AM would be okay, too...unless folks feel that would be too long to wait in this situation.

If y'all have first aid advice for this that she can do in the interim, that would be great, too.

Thanks so much!

I'm giving her the link to this thread, and will do what answering I can for her.

posted by batmonkey to Health & Fitness (14 answers total)

Emergency room?
posted by amanda at 4:52 PM on April 26, 2013

Response by poster: Only if there's absolutely no other alternative. I've already found some urgent care options, but I'm hoping to get her some recs from folks in the know in the area who can identify low-cost care options.
posted by batmonkey at 4:59 PM on April 26, 2013

linky

I don't know if it will help. It looks like Monday is the earliest you can get services. They do charge based in part on whether you have insurance, etc. You can call and ask. It might fall under their concern about communicable diseases, which has an after hours line.
posted by Michele in California at 5:33 PM on April 26, 2013

Wash it out for at least 5 minutes with a high powered stream of water, like a shower sprayer on the concentrated high power stream, directing the stream of water right at the wound if she can take it. Then cover it with a clean bandage. You can put some Bacitracin or Neosporin on as well.

If you had an 18 gauge needle to pierce the plastic top of a squeezable bottle then you could also use that to concentrate the stream of water.

Get tetanus vax ASAP. Wound is also at high risk for cellulitis.
posted by treehorn+bunny at 5:33 PM on April 26, 2013 [1 favorite]

County health departments usually offer the tetanus vaccine inexpensively, or sometimes free. I don't think they'll do wound care, though. Unfortunately, most county health departments are closed on the weekend.

I'm not a doctor, and this is not medical advice, but if the ER is absolutely not an option, perhaps your friend could see how long you can wait on the tetanus vaccine (if a few days don't make a difference, then perhaps she could get to the county health department on Monday). If the wound is a fairly uncomplicated puncture with minimal bleeding (and the nail isn't still in there), I would imagine that first aid for such a wound would be a thorough flush with saline and/or povidone iodine, both of which should be available at a drugstore. Follow up with a sterile dressing.
posted by jingzuo at 5:35 PM on April 26, 2013

If the shot alone is $200.00 at Walgreens I am having difficulty imagining it will be significantly cheaper anywhere else. I am one who almost always says--wait and see--I would NOT do this with a puncture wound--go to either an ER or urgent care center and get it treated. An ER will treat her--it will be expensive but she will get treatment and can probably work out a payment plan or negotiate a discount. Postponing this could not only escalate the problem but also the associated treatment costs.
posted by rmhsinc at 5:36 PM on April 26, 2013 [2 favorites]

I think the cleaning and bandaging aspect is what's making it expensive. I walked into an urgent care a few months ago needing a teatnus shot and it only cost $20. Call around and ask about just that. Also, I was told when I got my injury that it was actually better if it bled a little because it would flush out the wound. I don't know if that's bunk or not, so don't take my word for it.
posted by Mimzy at 5:46 PM on April 26, 2013 [1 favorite]

I found a list of low-cost / sliding-scale clinics in New Jersey; many seem to be open on Saturdays.

Batmonkey, has your friend had tetanus vaccinations in the past but just not in the last 10 years, or has she never had a tetanus vaccination? I'd be a lot more worried in the latter case.

I was unable to google up any information on how risky it is to delay the tetanus shot; most guidelines say "immediately" or "today". Personally I'd be OK waiting for the AM, but that's just a gut feeling, no science behind it.
posted by hattifattener at 6:14 PM on April 26, 2013

Without knowing how bad the wound is, it's tough to say if I'd be jumping up and down and screaming for your friend to go someplace a couple hours ago to get things cleaned and a shot or two. Questions that would be considered were I to see someone with a puncture wound: where/when did this happen, how bad does the wound look, what medical diagnoses does this person have, is there any evidence or concern for foreign bodies, and what, exactly, is the person's immunization history?

But knowing that puncture wounds, in general, make me jump up and down and scream, I'd say go to the ER. There's the risk of superficial and deep tissue infections caused by both aerobic and anaerobic bacteria (and spores, say, that cause tetanus). Whatever the case, tetanus toxoid/DTaP is warranted. Based on the nature of the wound, tetanus immune globulin may be given as well.

At any rate, my recommendation would be to try to find an urgent care clinic that's open. Barring that, head for the local ER. If your friend doesn't have insurance or cost is a concern, you could speak with the registration staff to get contact info of people at the hospital who may be able to help offset the cost.
posted by herrdoktor at 6:57 PM on April 26, 2013

I would advise the ER, preferably at a state/county hospital since they have to work with you on bills. We've been paying $25/month on a $3000 bill for 2 years now at a measly 2% interest. All I did was call and tell them we were going to be needing payment plans and they asked if we could do $25 a month and its been gravy from there.
posted by julie_of_the_jungle at 7:13 PM on April 26, 2013

There's a place called ID Care that has an office in Hillsborough, according to google - and they do would care - plus they have an emergency number. Try calling them.
posted by quodlibet at 8:21 PM on April 26, 2013

Also - this source (again googled) seems to say not to wait for a tetanus shot.
posted by quodlibet at 8:23 PM on April 26, 2013

Response by poster: This is all great info - thank you so much! I've pinged her steadily through the evening to get info to her, and haven't had an answer in a bit, so I really hope she's off taking advantage of something that was found.

I'll update when I know what happened.

Many, many thanks!
posted by batmonkey at 8:35 PM on April 26, 2013

Response by poster: She ended up having to work late last night, so she's just now calling around to places. I'm hoping she'll let me know who had the best answer once she's got it all figured out :)
posted by batmonkey at 7:43 AM on April 27, 2013