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Old 06-13-2011
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Arrow Treatment of acute tetanus infection

correct me if im wrong:

tetanus treatment include:

check ABC --> give oxygen --> place ptt on ventilator for prophylaxis
anti-tetanus serum
antibiotics (metronidazole)
diazepam (to relax the ptt)
NSAIDs (to reduce pain from tetanic spasms)
tetanus toxoid (if he/she hasnt got tetanus shot in last 10 yrs)

it seems to me (from looking at all the other treatments), this treatment plan is for ptt's in acute tetanus reactions. means they had the injury several days-weeks ago which is causing them to have a mild-severe tetanic reaction.

my questions are....
1. when is tetanus toxoid given? immediately as we're injecting in the Ig or sometime later when the ptt has stopped seizing (a few days- a week later)?

2. what does tetanus toxoid do at this point for the ptt when the toxin is already in the nerves and there's no way of neutralizing it no more.
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Old 06-13-2011
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thanks for the answer. thats what i said to the residents here. but they asked me several times if im sure it has to be given during the acute phase of infection. if im right, then we'll have to reconsider the treatment plan in this hospital. they are very old school here n if im to take this matter to the supervisor i need to know this for sure. but when im asked so many times if what i read is true, i start having doubts... but i have come across this treatment plan a few times while studying for my step 2ck and toxoid is a MUST even according to the WHO treatment plan for tetanus....

so really when do we give the toxoid? after the ptt stops having spasms or together with the Ig (at a diff site of course). as it is we need to inject 3000 - 5000 units of Ig and here each Ig prep is 250 units. which means the ptt is injected at various sites!
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Old 06-13-2011
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can i just add i love discussion like this.... more inputs please... i feel like this heading somewhere for me...
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Old 06-14-2011
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come on guys... more input plss.... am waiting....
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Old 06-14-2011
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tetanus toxoid (if he/she hasnt got tetanus shot in last 10 yrs) always we can do it?
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