When a patient says he cannot open his mouth, First think of Tetanus.

First examine the mouth carefully, for a painful abscess/ inflammation e.g. caries tooth with root abscess, Check abscess.

Inj. GENTAMYCIN 80mg. IM 8 hourly (Antibiotic Injection)

Tab. SUGANRIL 1 tds (Anti inflammatory)

Stem inhalations and formentations.

Refer to surgeon for incisions, if abscess is formed.

If there is nor painful lesion it is Tetanus

Confirmation:

Put a tongue depressor in moth to touch the throat. Of patients gags and opens the mouth, it is not tetanus.

If patient clinches the teeth with spasm of jaw muscles, it is Tetanus.

Look for associated features- rigidity of limb muscles, Neck stiffness and spasms and convulsions.

Prevention:

Only a general practioner can prevent Tetanus by immunizing every patient with injury, however minor.

Inj.  T.T ½ cc IM. And after 4 weeks. Plus, if the wound is very badly contaminated. Gove

Inj. Human Tetanus Immunoglobin 500 i.u IM or

Inj. A.T.S. 1500 i.u x A.T.D

Treatment of Tetanus:

Dark and Quiet Isolation room.

Inj. Human T.I.G 3000 i.u IM stat, upto 6000 i.u in severe case. Or

Inj. A.T.S 60,000 to 1 lac IM. I.V. x A.T.D x stat.

Inj. Pencilin 1 LAcs IM/I.V x A.T.D x 6 hourly.

Inj. CALMPOSE&actContent=TRISMUS (LOCK JAW)&redTo=disease&drg_tid=13102'>CALMPOSE&actContent=TRISMUS (LOCK JAW)&redTo=disease&drg_tid=13101'>CALMPOSE&actContent=TRISMUS (LOCK JAW)&redTo=disease&drg_tid=13102'>CALMPOSE 10mg slow I.V. of convulsions then,

Tab. CALMPOSE&actContent=TRISMUS (LOCK JAW)&redTo=disease&drg_tid=13102'>CALMPOSE&actContent=TRISMUS (LOCK JAW)&redTo=disease&drg_tid=13101'>CALMPOSE&actContent=TRISMUS (LOCK JAW)&redTo=disease&drg_tid=13102'>CALMPOSE mg. 2 hourly x oral through R.T.

In severe cases, Intreathecal injection Human T.I.G 500 i.u once and 3000 i.u daily till signs of recovery.

Incision, scraping and dressing of wound if any.

General nursing care, ryle’s tube feeding is required.

If spasms cause respiratory distress, tracheostomy and respirator.

Inj.  T.T

Inj. Human Tetanus Immunoglobin 500 i.u

Inj. A.T.S. 1500 i.u

Inj. Human T.I.G 3000 i.u

Inj. A.T.S

Inj. Pencilin