Tetanus secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.

Secondary Prevention

Currently, there is a large magnitude of people protected by the Tetanus vaccine which can prevent Tetanus for approximately 10 years. The people that would need specific post-exposure care are those who do not know exactly when their last Tetanus booster was. Post-exposure care may also be indicated in people who did not complete their primary prevention set of vaccinations. These patients will typically receive passive immunity with tetanus immune globulin (TIG). In a situation that would involve a large radius of exposure, the TIG will be reserved for the people who are least likely to have had a primary vaccination series. This includes people older than 60 and immigrants from regions other than North America and Europe. The TIG prophylactic dose that is recommended currently for wounds is 250 units administered intramuscularly (IM) for adult and pediatric patients. In circumstances in which passive protection is clearly indicated but TIG is unavailable, intravenous immune globulin may be substituted for TIG.

Medications

There are some medications that may be of help to reduce the proliferation of Tetanus. These include:

• Sedatives
  • Since tetanus causes such severe muscle spasms, medication is sometimes needed to attempt to calm these down. Sedatives can be used to help control the muscle spasms
• Beta blockers
  • Some of these beta blockers can help to reduce the action of involuntary muscles. This will help to combat the deleterious effects of the muscles spasms.
• Morphine
  • It may also be possible to use morphine to help relax the involuntary muscles. Morphine could also be used as a sedation method in combination with the controlling of spasms.