How to vaccinate neonates against tetanus

Newborn babies are very prone to accidents because they have just come out of their mother's belly and feel unfamiliar and curious about everything in the outside world. Most of them are also quite lively, so it is inevitable that they will get hurt. If the injury is serious, you will need to get a tetanus shot to prevent the situation from developing into something more serious. However, how to give newborns tetanus vaccination has become a big problem that troubles many parents.

The main points of treatment for neonatal tetanus are: controlling spasms, preventing infection and ensuring nutrition. Treatment for neonatal tetanus includes:

1. Antispasmodics: The convulsions of tetanus are caused by the combination of tetani bacillus toxin and nerve cells. Repeated severe convulsions can cause hypoxia of important organs, especially the brain, heart, and kidneys, leading to serious consequences. Convulsions consume a lot of energy and can also cause respiratory complications. Therefore, effectively controlling convulsions becomes the key to treating tetanus. Antispasmodics should be able to control convulsions, put the child in a drowsy state, and be awakened by stimulation. The ideal antispasmodic drug should be able to quickly control convulsions without respiratory depression and other side effects.

(1) Diazepam (Valium): It is the drug of choice. 0.3-0.5 mg/kg each time is injected slowly intravenously. After the convulsion stops, a gastric tube is inserted and nasogastric feeding is maintained. The dose is 2.5-8 mg/kg per day, divided into 6 times, so that the child is in a deep sleep state. When taking the medicine, pay attention to breathing and muscle tension to prevent side effects of the drug, and measure blood drug concentration when conditions permit.

(2) Sodium phenobarbital: It can be used as an additional treatment for patients who still have spasms during the use of diazepam. The initial loading dose is 15-20 mg/kg, slowly injected intravenously, and the maintenance dose is 5 mg/kg per day, injected intravenously once every 4-8 hours.

(3) 10% chloral hydrate: generally used as a temporary medication during convulsions. The dose is 0.5 ml/kg each time by gastric tube injection or enema.

2. Neutralization of toxin: Tetanus antitoxin can neutralize free tetanus toxin, but is ineffective against toxin that has been bound to gangliosides. Therefore, the sooner you use it, the better. Tetanus antiviral (TAT) 10,000-20,000 U is diluted and injected intramuscularly or intravenously, and another 3,000 U is injected around the umbilicus. A skin allergy test must be done before use. Those with a positive skin test need to be injected with desensitization therapy. Or tetanus immunoglobulin (TIG) 500U intramuscular injection. TIG has a high blood concentration and a half-life of up to 30 days. It will not cause allergic reactions and there is no need for allergy tests, but it is more expensive.

3. Antibiotics: used to kill Clostridium tetani. The use of antibiotics such as penicillin and tetracycline has a protective effect on animals infected with tetanus bacteria, and their efficacy has also been proven in clinical applications. Penicillin 200,000 U/kg per day, or cephalosporin, potassium nitrothione, intravenous drip, 15 mg/kg per day, divided into intravenous drips for 7-10 days.

4. Other treatments: Clean the navel with 3% hydrogen peroxide or 1:4000 potassium permanganate solution, and apply iodine to kill remaining tetanus bacteria. During an attack, those who suffer from hypoxia are given intermittent oxygen inhalation, and severe cases require endotracheal intubation and ventilator-assisted ventilation. Dehydrating agents should be used when there is cerebral edema.

5. Nursing nutrition: Place the child in a quiet, light-proof environment, maintain a stable body temperature, perform necessary operations in a centralized manner, and minimize stimulation to reduce convulsions. Clear respiratory secretions promptly and keep the respiratory tract open. The patient should fast at the beginning of the disease and be given parenteral nutrition. After the symptoms are alleviated, gastric tube feeding should be tried and gradually transition to oral feeding.