An 11-year-old boy presents to the emergency department (ED) with wounds to the right lower leg caused by hitting his leg against a stack of metal siding while riding his bicycle. This occurred in the backyard of his house about 1 hour prior to presentation. The patient’s mother reports a clean towel was used to apply pressure to the wound for a short time and then the wound was cleansed with soap and water. The child reports pain around wounds on his right calf but no other signs or symptoms of injury. The patient is generally in good health with no known allergies. Medical records confirm a tetanus, diphtheria, acellular pertussis immunization was given 2 months ago and all the patient’s other immunizations are up-to-date.

Examination: Temperature, pulse, and respiration are normal. The boy is alert and comfortable. He has a 2-cm diagonal laceration that extends through subcutaneous tissues and...

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