How to Treat the Patients with Tetanus?

Tetanus is a life-threatening bacterial infection commonly known as “lock jaw”. It is characterized by stiff or locked jaw and violent spasms which may be spontaneous or induced by noise, movements or painful convulsions. Painful muscle spasms may be strong enough to break the patients’ bones!

Intensive care is required to manage the patient suffering from tetanus. The following steps are undertaken to treat tetanus infection:

1. Admit the patient to a quite room in an intensive care department. Try to monitor the patient with minimum possible stimulation. Avoid light exposure to the patient and do not make noise in his/her room.

2. Explore the wound, clean it thoroughly and debride to get rid of dead and infectious tissue.

3. Give injection Benzyl penicillin 500000 units intravenous every 6 hour for 10 days.

OR

Metronidazole (Flagyl) 500 mg every 6 hour

4. Neutralize the circulating or unbound toxin. Give a single dose of tetanus immune globulin (TIG) 3000 IU intramuscular.

5. To avoid spasms, give injection diazepam (injection valium) 100 mg in 500-1000 ml of dextrose water.

6. Improve nutritional and fluid electrolyte status of the patient.

7. Tracheostomy and intubation/ventilator support is needed in severe cases.

Tetanus is caused by a neurotoxin known as "tetanospasmin" produced by an anaerobic bacterium called clostridium tetani. Tetanus can be prevented by tetanus toxoid (TT) vaccination. In the children below 7, tetanus vaccine is given in a series of 3 injections as extended program on immunization (EPI). In children above 7 and adults, tetanus toxoid is used when they receive any cut or puncture (especially contaminated one) if their last vaccine dose was given more than 5-10 years back or they do not know about their vaccination status. Booster dose of tetanus vaccine should be given every 10 years, even the person does not get any cut, injury or puncture.

Tetanus toxoid is marketed as "Tetanus Toxoid Vaccine Adsorbed" 0.5 ml in each ampoule. TT is given as an intramuscular (IM) injection.

TT injection

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Keywords: Tetanus management, Tetanus injection, Tetanus immune globulin, TIG, Benzyl penicillin, Metronidazole,