Emergency prevention of tetanus:
Emergency tetanus prophylaxis provides for primary surgical treatment of the wound and the creation, if necessary, of specific immunity against tetanus.
Emergency specific tetanus prophylaxis is performed with:
- trauma with violation of the integrity of the skin and mucous membranes;
- frostbite and burns of the second, third and fourth degrees;
- community-acquired abortions;
- Delivery outside medical institutions;
- gangrene or necrosis of any type of tissue, abscesses;
- penetrating lesions of the gastrointestinal tract;
- bites by animals.
For emergency specific prevention of tetanus use:
- AC-anatoxin;
- human tetanus immunoglobulin (ICPS);
- in the absence of HFRS - anti-tetanus serum.
AC-anatoxin and HFRS are administered in accordance with the instructions for the use of these drugs.
The scheme for selecting preventive agents for emergency specific tetanus prophylaxis is presented in Table 1.
For the purpose of emergency tetanus prophylaxis, anti-tetanus serum is administered subcutaneously in a dose of 3000 IU.
Before the introduction of anti-tetanus serum intradermal with horse serum diluted 1: 100 serum. To place the sample, use syringes with a 0.1 ml division and thin needles. The diluted serum is injected intradermally into the flexor surface of the forearm in a volume of 0.1 ml. The reaction is taken into account after 20 minutes.
The sample is considered negative if the diameter of the edema or redness appearing at the injection site is less than 1 cm. The sample is considered positive if the swelling or redness reaches a diameter of 1 cm or more.
With a negative intradermal sample, the anti-tetanus serum is injected subcutaneously in an amount of 0.1 ml (a sterile syringe is used, the opened ampoule is closed with a sterile napkin). In the absence of a reaction, after 30 minutes, a whole sterilized dose of serum (for prophylactic purposes), intravenously or into the spinal canal (with a therapeutic purpose) is administered using a sterile syringe.
With a positive intradermal test or the occurrence of an anaphylactic reaction to a subcutaneous injection of 0.1 ml of anti-tetanus serum, its further administration is contraindicated. In this case, the introduction of HFI is shown.
The drug is registered in the prescribed form with the date of vaccination, dose, drug manufacturer, serial number, response to the administration of the drug.
Treatment of tetanus:
Anti-tetanus serum is administered to patients at the earliest possible time from the onset of the disease at a dose of 100,000-200,000 ME.
Serum is injected intravenously or into the spinal canal (after testing the sensitivity to a foreign protein (sample with serum of horse purified diluted 1: 100) .In Depending on the severity of the disease, the introduction of serum is repeated until the disappearance of reflex spasms.