Treatment of Tetanus

Abstract

In a series of 55 children with tetanus in which routine tracheotomy was not done, 27 (49%) died, while in a comparable group of 27 children in which tracheotomy was done in 14 severe cases and I.P.P.R. was used in 4, there were 3 deaths (11%). Apart from the use of mephenesin in some of the latter group, treatment was essentially the same. Reasons are given why tracheotomy should be part of the routine treatment of severe tetanus. The indications for and the technique and subsequent care of the tracheotomy in patients with tetanus are described. Even if I.P.P.R. is available, it is felt that tracheotomy and sedation should be tried first, and only if this treatment fails, as judged by certain criteria, should I.P.P.R. be applied. We thank Professor F. J. Ford for facilities, and Dr. D. V. Maytham, who did most of the tracheotomies. We are also grateful to Dr. J. Burger, medical superintendent of Groote Schuur Hospital, and Dr. J. F. W. Mostert, of the Red Cross War Memorial Children's Hospital, for permission to publish. © 1961, British Medical Journal Publishing Group. All rights reserved.