Whether the pencil poke hand is red and swollen with pus needs tetanus, mainly need to be based on the patient’s tetanus vaccination, if tetanus completed 4 doses of vaccine and within 5 years of validity is not required to play tetanus, if tetanus vaccination 4 doses and within 5-10 years need to play tetanus vaccine, if the immunization status is not known need to play tetanus vaccine and globulin. According to the Chinese Expert Consensus on Tetanus Immunoprophylaxis issued in 2018, tetanus, including tetanus toxoid vaccine and tetanus immune globulin, is only required for non-full immunization or if the immunization history is unknown and for unclean or contaminated wounds. Full immunization means completing 4 doses of tetanus vaccine on schedule and the last dose over a 5-year period to ensure immunity. Therefore, patients with pencil poke wounds who are fully immunized and within 5 years of the last dose do not need tetanus; patients with pencil poke wounds who are fully immunized but within 5-10 years of the last dose need tetanus toxoid vaccine; and patients who are not fully immunized or whose immunity is unknown need tetanus toxoid vaccine and tetanus immunoglobulin. Combined with redness and swelling of the patient’s hand with purulent discharge, prompt medical attention is needed for debridement and dressing, regular dressing changes, and antibiotic treatment with amoxicillin.