welcome to my
presentation:
Made by :saeed ullah
Topic: Tetanus
Mind Activity
• write sunday in 4 boxes
Objectives
what is tetanus
epidemiological triads
sign and symptoms
pathophysiology
diagnosis
complication
prevention
treatment
nursing care
TETANUS
tetanus also called lockjaw
it is a bacterial disease characterized by muscle spasms
Muscle spasms sudden,involuntary and painful contraction of a
muscle
spasms begin in the jaw and then progress to the body
only vaccine preventable disease that is infectious but not contagious
EPIDEMIOLOGICAL TRIADS
it consists of three components
Agent;cause of disease (clostridium tetani)
• A gram positive,spore forming anaerobic bacterium which produce
tetanuspasmin,a potent neurotoxin that interferes with nerve
signaling
Host;susceptible hosts includes,
• unvaccinated individuals
• elderly peoples
• peoples with wounds
• post surgical patients
CONTI....
Enviroment; condition that favor spread
• contaminated soil or surface
• poor wound hygiene
• non sterile delivery practices
• warm and humid climates
CONTI...
Route of Entry
Apparently trivial injuries
Animal bites/human bites
Open fractures
Burns
Gangrene
In neonates usually via infected umbilical stumps
Abscess
Parenteral drug abuse
Sign and symptoms
fever
sweating
high blood pressure
lockjaw(trismus)
muscle spasms
seizures
difficulties in breathing
opisthotonus(severe hyperextention of neck)
Pathophysiology
clostridium tetani spore enter the body through wounds
in anaerobic conditions the spores germinate into active bacteria
active bacteria produce tetanospasmin
tetanuspasmin bind to pheripheral nerve terminals at the neuromascular
junction
it travesl retrograde(backward) through the motor neurons toward the
spinal cord and brainstem
it block the release of inhibitory neurotranmitter,GABA and,GLYCINE
this blockage leads to unopposed excitatory signals, resulting in involuntry
muscle contraction
Diagnoses
tetanus diagnosed primarily on clinical sign and symptoms rather
than laboratory tests
key clinical signs includes lockjaw,dysphagia,painful spasms
Complication
breathing difficulties
fracture
pulmonary embolism
pneumonia
brain damage
death
Prevention
Vaccination:(WHO) recommends a primary series of three doses of tetanus
vaccine, followed by three booster doses to maintain life-long immunity.
Primary doses:
• At 2 months old — DTaP (1st dose)
• - At 4 months old — DTaP (2nd dose)
• - At 6 months old — DTaP (3rd dose)
Booster doses:
• 1st booster;at 12 － 23months…… TdaP(4th dose)
• 2nd booster: at 4 － 7years …… TdaP(5th dose)
• 3rd booster: at 9 － 15 years ……TdaP(6th dose)
CONTI...
Pregnant women:The WHO recommends a two-dose tetanus toxoid
vaccine (TT) schedule for pregnant women who have not been
vaccinated before, or have an incomplete vaccination record.
The first dose should be given as early as possible during pregnancy,
ideally during the first trimester.
The second dose should be given at least 4 weeks after the first dose
. A third dose is recommended 6 months after the second dose for
long-term protection.
NOTE:Tdap is the vaccine for older children and adults and DTaP is a
vaccine for infants and young children
CONTI
Wound care:clean wound thoroughly,especially deep wound.
To help prevent tetanus, immediately clean and apply first aid to all
cuts, scrapes, or other breaks in the skin and wash your hands often
with soap and water.
Post- exposure prophylaxic(PEP); Tetanus Immune Globulin (TIG):
TIG provides immediate passive protection against tetanus toxin.
It is recommended for individuals with contaminated wounds and
unknown or incomplete vaccination status.
Treatment
Neutralizing the Toxin:
• Tetanus Immune Globulin (TIG): TIG, also called tetanus antitoxin,
provides immediate passive immunity by neutralizing the tetanus
toxin in the body
Muscle relaxans:
• Medications like benzodiazepines (diazepam) or other muscle relaxants
are used to control severe muscle spasms.
Other drugs may be given to provide sedation, relax the muscles and
relieve pain. Due to the extreme potency of the toxin, immunity does
not result after the disease.
Nursing interventions
Remove and destroy the source of the toxin through surgical exploration
and cleaning of the wound (debridement).
Bed rest with a non stimulating environment (dim light, reduced noise,
and stable temperature) may be recommended.
Sedation may be necessary to keep the affected person calm.
Respiratory support with oxygen, endotracheal tube, and mechanical
ventilation may be necessary.
CONTI...
Halting production of toxin within the wound.
Neutralization of unbound toxin.
control of mascle spasms.
Management of autonomic instability.
Supportive therapy.
Management of complications.
prevention
Mcqs about tetanus
Mcq. , which vaccine is recommended to maintain tetanus immunity in
older children and adolescents?
A. Tdap
B. MMRV
C. DTaP
D. Hepatitis B
conti...
mcq. What is a potential complication of tetanus?
A. Encephalitis
B. Respiratory failure
C. Myocarditis
D. Hydronephrosis
conti...
mcq. A 10-year-old child sustains a deep cut while playing. Her last tetanus
booster was 6 years ago. What is the appropriate action?
A. No action needed
B. Administer a tetanus booster shot immediately
C. Wait and see if symptoms develop
D. Administer antibiotics only
conti...
mcq. What is the recommended frequency for tetanus booster
vaccinations in adults?
• A. Every 5 years
• B. Every 10 years
• C. Every 15 years
• D. Once in a lifetime
Any questions
