ICU Management of Tetanus

Abstract

Tetanus is a major public health concern in low socio economic countries and it carries a high mortality rate. However, the incidence of tetanus in developed nations has greatly reduced due to an excellent vaccine program. Tetanus is caused by a neurotoxin released by Clostridium tetani. C. tetani is a spore-forming bacterium that is widely distributed in soil and it is also found in the intestines and feces of animals such as horses, sheep, cattle, dogs, cats, rats and guinea pigs. The mortality is because of various complications due to muscle spasms, autonomic dysfunction, as well as due to prolonged critical care. Management of tetanus with its complications is in an intensive care unit and the goals of management include stopping further toxin production, neutralization of unbound toxin, management of the airway, control of muscle spasm, treatment of autonomic dysfunction and general supportive management. The effective method of preventing tetanus is by immunization with tetanus toxoid containing vaccines. The vaccine is cheap, effective and safe for all age groups.