Tetanus prophylaxis and types of immunitynewnewv

this slide will know you about tetanus prophylaxis and tupes of immunity.

1. Tetanus prophylaxis and types of Immunity Dr. Shamsul Ahmad Yousufi (HO) Department of G. Surgery .

2. Introduction to tetanus Pathophysiology Clinical types Clinical features Management Tetanus prophylaxis Types of immunity Contents

3. Is an acute infectious disease caused by toxin producing anaerobe clostridium tetani that commonly found in soil, saliva, dust, and manure. P roduce a toxin that affect the brain and nervous system, leading to spasm and stiffness in the muscles. What is Tetanus?

4. Apparently trivial injuries Animal bites Open fractures Burns Gangrene In neonates usually via infected umbilicus Abscess Routs of entry

5. Pathophysiology

6. Pathophysiology cont …

7. Clinical types of tetanus

8. Risus sardonicus : Contraction of the muscles at the angle of mouth and frontalis . Trismus : also called lockjaw is the spasm of Masseter muscles. Opisthotonus : spasm of extensor of the neck, back and legs to form a backward curvature . Tetany : Prolonged muscular action causes sudden, powerful, and painful contraction of muscle groups. Clinical features

9. If respiratory muscles involved ---Apnea Drooling Excessive sweating Fever Hand or foot spasm Irritability Swallowing difficulty Uncontrolled urination or defecation. Clinical features cont …

10. Opisthotonus Clinical features cont …

11. Risus sardonicus : Clinical features cont …

12. Lockjaw or trismus . Clinical features cont …

13. General measure Goal is to eliminate the source of toxin. Admit in a dark and quiet room in ICU. Continuous careful observation and cardiopulmonary monitoring. minimize stimulation. Protect airway. Wound management wound should be cleaned and necrotic and foreign material should be removed. Management

14. wound is then lightly bandaged to prevent formation of local anaerobic environment. C ontrol of spasm Minimize the stimuli . Anticonvulsants. S edatives Muscle relaxants Neutralize the remaining unbound toxin HTIG/ATS Elimination of C. tetani Penicillin G, Metronidazole. Management cont …

15. Tetanus prophylaxis depend on the nature of the lesion and patient’s immunization history it may include tetanus immunoglobulin (TIG) and tetanus toxoid (TT) containing vaccines. The emergency department patient encounter provide an ideal opportunity to screen the patient for adequate tetanus immunization and provide it when necessary. Tetanus prophylaxis

16. Patient seen in emergency department with clean, minor wounds are considered adequately immunized if they have received primary immunization and have had a booster shot within the past 10 years. And if a wound is dirty (which includes wound contaminated with saliva, feces or dirt, and burn injuries) then a booster within the 5 years is necessary to ensure immunization. If the patient has not received primary immunization or unsure then passive immunity with TIG is provided. Tetanus prophylaxis cont …

17. A wound sustained more than 6 hours before surgical treatment Deeper than 1cm Soil, feces contamination Burns , missiles, crush, frostbites and animal bites Devitalized tissues Puncture or penetrating wounds Infected cord in neonates Surgical incision contamination Tetanus prone wounds

18. Tetanus prophylaxis

19. Tetanus is completely preventable disease by active tetanus immunization. Tetanus vaccine is a component of Expanded program on immunization(EPI). Begin in infancy with DTP series of shot. Prevention

20. Active immunization 1 st dose at 6 th week (DPT) 2 nd dose at 10 th week (DPT ) 3rd dose at 14th week (DPT ) 1 st booster at 18 th week(DPT) 2 nd booster at 6 th year (DT) 3 rd booster at 10 th year (TT) Duration of active immunity is 5 years after primary series . Dose is 0.5ml IM Prevention cont …

21. Passive immunization 1 . Tetanus immunoglobulin(TIG ) It is used for prophylaxis and therapy. provide protection for 30 days Prophylactic dose is 250 IU IM and therapeutic dose is 1000 – 10000 IU IM. 2. Teatnus Antitoxin serum (ATS ) Protection last for 7 - 15 days. prophylactic dose is 1500 – 3000 IU IM therapeutic dose is in neonate is 10000 IU S/C, IM, IV and in children is 40000 – 60000 IU(half IM and half IV). Prevention cont …

22. Immunity is the ability of the body to protect against all types of foreign bodies like bacteria, virus, toxic substances that enters the body. Immune response is the reaction of the body against any foreign antigen. I mmunity

23. 1.Innate immunity : I t is also called natural or native immunity, consist of mechanism that exist before infection and are capable of rapid responses to microbes. It comprise of 4 types of defense barriers Anatomical barriers P hysiologic barriers. Phagocytic barriers. Inflammatory barriers. Types of immunity

24. Acquired immunity Also called adaptive immunity is the immunity that is developed by the host in its body after exposure to suitable antigen or after a transfer of anti bodies or lymphocyte from an immune donor. Characteristic of acquired immunity A ntigenic specificity Diversity Immunologic memory Self/non self recognition Immunity con…

25. 1. Active immunity it is induced by natural exposure to a pathogen or by vaccination. 2. Passive immunity Achieved by transfer of immune products such as antibody or sensitized T cells from an immune individual to non immune one. Types acquired immunity