treatment

How to Treat Tetanus?


Things to note:
  • Keep airway.
  • Check ECG and blood pressure.
  • Maintenance and replacement of IV fluids.
  • Wound management is essential if foreign bodies are to be debridged and removed.

Medical Treatment:
Spasms for rigidity:
* Diazepam, IV, 10 mg 4 hours per day, 24 hours per day, then consider oral route.
  • Titrate to action.
  • Sometimes dose levels of 50-100 mg 2 hours are used.
Muscle relaxants should be sparingly used and can increase autonomous instability.
To eradicate bacteria:
* Benzylpenicillin( penicillin G), IV, 5 million units for 10 days 6 hours per day.
OR
Oral metronidazole 400 mg 8 hours 10 days.
For passive immunization:
* immunoglobulin tetanus, IM, 3 000 units per dose.
In case of active immunization of all patients as clinical tetanus, immunity does not always apply:
* Tetanus toxoid vaccine, IM, 0.5 mL, total 3 doses:
  • On admission,
  • At 4 weeks and
  • at 6 months.
For fever, combine with mechanical cooling:
* Paracetamol, orally, 1 g 4-6 hours when required for a maximum of 4 doses per 24 hours.
For shock, dehydration, hydration maintenance:
* IV fluids, plasma volume expanders.
As prophylaxis for deep vein thrombosis:
* Heparin, SC, 5 000 units 8 hours
For pain:
* Morphine, slow IV, 10 mg diluted with 0.9 percent sodium chloride for 45 minutes.
  • After 4-6 hours, repeat.

When to refer:
  • All cases to a facility with artificial ventilation resources.

treatment