Tetanus toxoid is used to provide prevention dangerous disease- tetanus. Tetanus bacillus is life-threatening. It enters the body through microdamages on the skin. A person becomes infected with a particularly dangerous pathology when receiving an agricultural injury. A contributing factor to tetanus is an abortion performed outside a hospital. The risk of infection is also high if childbirth is carried out in unsterile conditions. In such situations, tetanus prophylaxis should be provided. A necessary measure when providing emergency assistance is the administration of tetanus toxoid.
It occurs due to the influence of microorganisms whose spores are found in the soil. These spores fall into the ground from gastrointestinal tract animals. When microorganisms enter the human body, they become bacteria. Infectious agents that cause tetanus multiply and produce large number poison called toxin. It spreads across nerve fibers, as well as the bloodstream.
When the nervous system is affected, spasm of the back and jaw muscles occurs. The first symptom of tetanus is the inability to open your mouth. A serious illness is caused by spasms of the masticatory muscles. As the toxin progresses, it affects the facial muscles.
The second symptom of pathology is a smile that is not typical for a person. The patient also experiences back muscle spasms. The patient is forced to bend, his torso takes on an arched shape. The patient realizes the severity of the pathology, but cannot provide first aid to himself.
After these symptoms, hemolysis occurs, the blood cells dissolve. The disease is often fatal. Tetanus can be fulminant. In this case, it ends tragically. The chronic form is long and painful, but with treatment the patient recovers.
Tetanus toxoid contains inactive toxins (spores that lead to the development of tetanus). To neutralize these microorganisms, you need to carry out procedures using high temperatures and formaldehyde substances. As a result, the toxin loses its properties. Serum intended for vaccination promotes the formation of tetanus immunity.
Tetanus toxoid is used to prevent tetanus and diphtheria. The drug contains components that are antigens of the microorganism that causes tetanus. Anatoxin is used in pure form or added to combination DTP preparations.
Tetanus toxoid is an adsorbed drug. Its manufacturer is Microgen. When the active components enter the human body, antibodies are formed that prevent infection. The administration of the drug is part of medical care.
Thanks to the serum, the body develops immunity against a dangerous disease. In addition to the main active ingredient, the medicine contains formaldehyde and aluminum hydroxide. The drug is injected under the skin. If it was administered 3 times in accordance with the vaccination schedule, the duration of immunity is more than 7 years. The dosage of tetanus toxoid is 0.5 ml. If the patient has not been vaccinated childhood, doctors prescribe the same dose, the interval between vaccinations should be 35 days.
The procedures are carried out in accordance with the schedule. Repeated vaccination is carried out after 8 months. The serum must be administered every 10 years. If 5 years have passed since the first administration and there is a threat of infection, the doctor prescribes emergency immunization using this drug. The dosage is the same. In parallel with the toxoid, immunoglobulin is administered. For extensive skin lesions, toxoid is injected around the wound.
The doctor prescribes emergency administration of the drug two days after the injury or improper labor activity. Indications for use of the serum:
After the patient has received emergency care, the doctor will administer the IPS. Tetanus toxoid may produce side effects. Some patients are diagnosed with swelling of the skin. The serum may cause a burning sensation at the injection site. Such symptoms disappear within 1 to 2 days.
There are also common side effects. These are fever, weakness, migraine. Possible exacerbation of allergies. In most cases, side symptoms do not pose a threat to health. Their duration does not exceed three days. Tetanus toxoid can cause allergies. This disease is manifested by hives, itching, and increased body temperature.
The most dangerous complication- Quincke's edema. It leads to disruption respiratory function. With this dangerous condition the skin turns pale, the temperature rises, the voice becomes hoarse. Quincke's edema is characterized by severe cough, damage to the larynx.
Having discovered such manifestations, you need to urgently call an ambulance. To avoid side effects, the serum is administered in a clinic where there are anti-shock treatments. The patient should stay in the hospital for one hour. If the administration of the serum leads to side effects, the patient will be immediately provided with help.
The doctor does not prescribe tetanus toxoid if the patient has an exacerbation of chronic diseases. Serum is not administered for ARVI, which is accompanied by elevated temperature. You should wait for remission and only then use the drug. 35 days must pass from the day of recovery. The drug can be prescribed to a patient who has a skin form of allergy.
Permanent contraindications:
Immunodeficiency and HIV are not a contraindication for serum administration, however, remission should be waited for. If there is a history allergic disease, you need to take antihistamines. They are prescribed by a doctor, dosages are individual. If side effects are detected, precautions should be taken.
The vaccine contains immunoglobulins G, which suppresses tetanus toxin. It can be used alone or in combination with toxoid. The serum is used for prevention especially dangerous pathology. The doctor prescribes it if the patient detects hypersensitivity to the drug. Immunoglobulin is administered intramuscularly into the femoral area. The doctor opens and uses the serum, observing all antiseptic requirements.
Opened medicine is unsuitable for storage. It is used immediately. If you have in front of you a serum that has changed physical properties(there is sediment or flakes, there is noticeable cloudiness), you should discard it and buy a new one. Changes in properties may be due to improper storage. The dosage of the drug is checked with a doctor.
There are cases when immunoglobulin gives adverse reactions. Some patients experience swelling of the skin. This side symptom is usually harmless and goes away after a couple of days. The administration of serum can lead to an increase in body temperature (it reaches subfebrile values). The most severe complication is anaphylactic shock. It is observed in rare cases. After administering the medicine, you should be under the supervision of a doctor for half an hour. If necessary, antishock agents will be used.
The serum has one contraindication - individual hypersensitivity to individual components. The vaccine is not intended for administration intravenously. It should be in a tightly closed bottle. It is prohibited to use the remnants of the therapeutic and prophylactic agent. If the doctor has prescribed the simultaneous use of immunoglobulin and toxoid, he uses different syringes and injects the drugs into different areas of the body. The patient is prohibited from taking any other medications.
It is intended for the prevention of whooping cough, tetanus and diphtheria. DPT contains deactivated microorganisms that provide prevention dangerous diseases. The drug is administered to children over three months of age. When vaccinating, the doctor follows the rules of antiseptics. The drug in an opened bottle is not intended for storage. DPT is administered intramuscularly into the shoulder area. The doctor follows the vaccination schedule.
The patient may experience side symptoms: weakness, fever, swelling, allergies, itching. The drug is strictly prohibited if there is hypersensitivity to it active components. In this case, convulsions and severe diseases of the nervous system may occur. If a child or adult is diagnosed with pathologies in the acute stage, it is necessary to wait for recovery and then administer DPT (duration of remission is 4 months). Diphtheria-tetanus toxoid, the active component of the vaccine, provides long-term prevention of deadly pathologies. Tetanus toxoid is given to prevent tetanus. If the patient is allergic to the components of the serum, the doctor uses an analogue.
People don't even realize how many invisible tiny enemies surround them in everyday life. Microscopic creatures are much more dangerous than predators, because they are invisible and intangible until they penetrate inside a person. And the tetanus bacillus is one of the most dangerous representatives of the microcosm, waiting for an opportunity to penetrate the human body through a scratch.
Tetanus infection most often occurs from street and agricultural injuries. However, out-of-hospital abortions and childbirth are also dangerous due to tetanus bacillus infection. It is precisely in such cases that urgent prophylaxis of tetanus may be required. Tetanus toxoid is used to provide emergency care. Let's find out what toxoid is, why and in what form it is used.
Having reached the nervous system, the poison affects the motor muscles - first the chewing muscles, and then the back extensors. The first signs of the disease appear in severe difficulty when trying to open the mouth due to spasm of the masticatory muscles. Spread of the toxin facial muscles The face causes them to stretch in such a way that a “sardonic smile” characteristic of tetanus is formed.
With the development of tetanus, a tonic spasm covers the muscles of the back in such a way that the body takes the shape of a strongly pronounced arc, with supporting points on the back of the head and heels. The horror of the infection is that a terrible spasm occurs with the patient fully conscious, who is unable to take a breath due to the spasm. respiratory muscles. The funeral procession of the tetanus bacillus poison throughout the body is not limited to this. The strongest toxin, tetanus, when it enters the bloodstream causes hemolysis (dissolution) of blood cells. Death is the real deliverance from the torments of hell.
Tetanus is distinguished by a variety of forms - from fulminant manifestations to fatal to chronic course which ends in recovery.
What is tetanus toxoid? Anatoxin is biological drug, which is obtained from toxins of various bacteria by neutralizing them in various ways. Most often, exposure to formaldehyde at a temperature of 39.0–40.0 °C is used to inactivate bacterial toxins. The toxoid neutralized in this way loses its pathogenic properties, while acquiring the ability to form immunity against the tetanus toxin. Toxoids are used to prevent tetanus or diphtheria.
Tetanus toxoid contains exclusively tetanus bacillus toxin antigens and has a high ability to induce antibodies. In addition to being used in its pure form, tetanus toxoid contained in the combined vaccines DTP, ADS and ADS-M.
Tetanus toxoid is a purified adsorbed liquid preparation(AS-anatoxin). Its manufacturer is Russian company NPO Microgen. After administration of toxoid, antibodies against infection are formed in the blood. Tetanus toxoid is administered to create antitoxic immunity against tetanus, as well as in emergency care.
0.5 ml (1 dose) contains:
AS-anatoxin is produced in ampoules of 1 ml containing 2 doses, in dosage form suspensions for subcutaneous use. Immunity after triple vaccination takes at least 10 years to develop.
AC toxoid is administered in a dose of 0.5 ml subcutaneously into subscapular region. The use of the drug is recommended according to the following regimens.
The use of an emergency vaccination regimen is acceptable within 1–20 days after injury or childbirth. The main indications for the use of an accelerated regimen of tetanus toxoid:
When providing emergency care, surgical treatment of the wound is performed, around which toxoid is injected. In addition to AS-toxoid, IPSP or PSS is administered during emergency care.
The use of tetanus toxoid, as with any drug, may cause side effects. Most often, the reaction is limited to manifestations at the injection site. Hyperemia, burning and swelling usually disappear within two days. Common side effects of tetanus toxoid include fever up to 38.0 °C, malaise and headaches. In some cases, an exacerbation of allergic diseases is observed. However, all reactions last no more than 3 days.
In rare cases, it happens that an allergy develops to tetanus toxoid. It manifests itself as urticaria, fever, skin itching. In exceptional cases, it is possible to develop angioedema, which is manifested by the following symptoms:
If such symptoms appear, you should immediately consult a doctor. Considering possible complications AS-toxoid, its administration is permissible only in rooms adapted for providing anti-shock therapy. As a precaution, you can move away from the site of toxoid injection no earlier than half an hour. In the event of an unexpected reaction, the patient will be provided with emergency assistance.
Attention! There are no contraindications for tetanus toxoid during emergency treatment.
The instructions for tetanus toxoid indicate contraindications only for routine immunization. In case of exacerbation chronic diseases or ARVI with fever or exacerbation of allergic diseases, toxoid should be administered no earlier than 30 days after complete recovery. Skin forms allergies are not a contraindication.
Permanent contraindications to the use of tetanus toxoid are:
Immunodeficiency diseases and HIV infection are a temporary contraindication. Administration of AC toxoid to patients suffering from these diseases is indicated no earlier than a year after the onset of remission. Vaccination of persons with a history of allergic diseases should be carried out against the background of the use of antihistamines.
In conclusion, let us recall that AS toxoid is used for immunization of the population, as well as in providing emergency assistance against tetanus. In addition, toxoid is used when immunizing donors to obtain specific immunoglobulin against tetanus. Since toxoid in rare cases causes an allergic reaction, precautions must be taken. On the day of vaccination, an examination by a doctor is required to measure the temperature. If a person is prone to allergies, a few days before vaccination should be taken antihistamines.
Tetanus is infectious disease, which is characterized by damage to the central nervous system, development spastic paralysis caused by exotoxin (tetanospasmin) of the pathogen. The infection is provoked by the mobile gram-positive anaerobic spore-forming bacillus clostridium tetani.
Infection of a person occurs through contact - when bacterial spores enter areas of damage to the skin or mucous membranes during injuries accompanied by deep punctures or lacerations, burns, frostbite, trophic ulcers, injections narcotic substances. You can also become infected by doing surgical operations, abortion or delivery without proper aseptic conditions. Cases of the development of tetanus in patients with chronic otitis media have been described.
General characteristics tetanus.
For routine immunization and emergency prevention of tetanus, the following vaccination preparations are used:
Tetanus toxoid (AS-toxoid) is a weakened toxin that is not toxic (that is, cannot cause symptoms of tetanus). The use of this vaccination drug allows you to develop immunity with the formation of human body antitoxin.
PSS is protein fraction blood serum, which contains specific immunoglobulins (antitoxin) of horses hyperimmunized with AC toxoid or the toxin itself. The drug is purified and concentrated. Available in the following forms:
The PSS (marked in blue) comes with ampoules (marked in red) containing 1 ml of serum diluted 1:100. The latter are used to determine the patient’s sensitivity to horse protein, that is, for an intradermal test. It must be performed by everyone before the introduction of PSS.
An intradermal test is not done if it was performed with anti-rabies immunoglobulin (anti-rabies) 1-3 days before the PSS injection. Persons with positive result In this study, PSS administration was contraindicated.
PSCH is a solution of the gamma globulin fraction of the blood of human donors who have been immunized with AS toxoid. Administration of 1 dose of immunoglobulin (250 IU) provides a protective level of antitoxin in the blood serum for 3 weeks. This significantly exceeds the duration of action of antitoxins horse serum.
The following are subject to vaccination against tetanus:
Revaccinations against tetanus are carried out according to the national vaccination calendar, together with revaccinations against diphtheria. They are given by injection combination vaccine(ADS-M).
If the adult has not previously been vaccinated, perform a double injection of AC toxoid in a dose of 0.5 ml via subcutaneous injection with an interval of 30-40 days.
The first revaccination is carried out 9-12 months (the interval can be increased to 2 years) after completed vaccination. It consists of a single subcutaneous injection of AC toxoid under the shoulder blade in a dose of 0.5 ml. Subsequent revaccinations are similarly performed every 10 years with AC toxoid or ADS-M toxoid.
In regions where there is an increased incidence of tetanus, the intervals between vaccinations are sometimes reduced to 5 years.
Representatives of certain professions (hard-to-reach groups) and the unorganized population can be vaccinated according to a simplified scheme:
If an adult was previously vaccinated, but more than 10 years have passed since the last injection of the vaccine, he is simply given another revaccination without violating the deadlines for the others.
Emergency (post-exposure) prophylaxis of tetanus refers to the implementation of certain measures when there is a risk of developing this infection. These include primary surgical treatment (PST) of the wound and the creation, if necessary, of tetanus immunity. Prevention of tetanus is divided into nonspecific and specific.
The procedure is indicated for the following conditions:
There is a scheme that allows you to choose one or another type of specific tetanus prophylaxis, which is carried out according to epidemic indications. Immunization tactics are determined depending on the nature of the wound and vaccination history. The latter, in accordance with the classification of wounds, are divided into infected and non-infected. Their signs are the following:
Infected wounds are considered to be penetrating wounds of the intestine, necrosis, abscesses, and animal bites. As well as an umbilical wound that occurred during childbirth and an abortion that occurred outside a health care organization.
Types of prevention:
| Type of prevention | Contingent, vaccination history and nature of the wound | Scheme |
| Not carried out |
| - |
| Active (ADS-M) |
| 0.5 ml |
| Active (AC) | All ages (incomplete course of immunization - 1 preventive vaccination), less than 2 years from last vaccination, uninfected wound | 0.5 ml |
| Active-passive (AS+PSCHI/PSS) |
| 1.0 ml (AS)+250 IU (PSCHI)/3000 IU (PSS) |
| All ages (incomplete course of immunization - 1 preventive vaccination), less than 2 years from the last vaccination, infected wound | 0.5 ml (AS)+250 IU (PSCHI)/3000 IU (PSS) | |
| Passive (PSCHI) | Children under 5 months, unvaccinated, regardless of the nature of the wound | 250 IU |
The tactics for choosing the type of tetanus prophylaxis in newborns in case of birth outside a health care organization and in children under 5 months who have not received routine preventive tetanus vaccinations depend on the vaccination status of the mother:
All persons who have received active-passive tetanus prophylaxis must receive a vaccine - 0.5 ml AS (ADS-M) after 9-12 months to complete the course.
If the patient's vaccination status is unknown, then the choice of type of prophylaxis will depend on the results of determining the titers (level) of tetanus antitoxin in the blood serum. It must be examined before the start of the PSO wounds:
After recovery, the patient requires tetanus immunoprophylaxis, since the amount of toxin that can cause the disease is most often insufficient for the development of protective immunity.
The human body may react differently to the introduction of a vaccine. Depending on its type, certain side effects develop. The exception is PSCHI, because it is low-reactogenic.
Injections of AC toxoid can cause both a local (redness, swelling, the injection site may be slightly sore) and a general reaction (malaise, increased body temperature).
People sometimes experience allergic reactions to the administration of PSS. Depending on the time of development after injection, they are divided into:
Clinically, these reactions are manifested by a complex of symptoms of serum sickness (fever, itching, various rashes, joint pain, enlargement of the spleen, liver and lymph nodes), in rare cases - anaphylactic shock.
Given the likelihood of the latter occurring, each vaccinated person must be observed for 1 hour in conditions that allow adequate medical care to be provided.
The main contraindications to tetanus immunoprophylaxis are the following:
Tetanus is a serious infectious disease that affects nervous system. The danger of infection is that the effect on the head and spinal cord leads to paralysis of the muscles, including the respiratory one. This can lead to breathing problems and danger to human life. The disease is difficult to treat. However, means have been invented to prevent it. Purified, adsorbed liquid tetanus toxoid for routine and emergency prevention of tetanus is one of them.
Tetanus toxoid is available in the form of a solution for subcutaneous administration. One ampoule contains 0.5 or 1 milliliter. One package contains ten ampoules along with instructions and a scarifier.
The composition of the drug includes:
Tetanus toxoid is available in two versions: with and without a preservative. Thiomersal, a mercury compound, is used as a preservative.
Anatoxins are toxins secreted by bacteria, which after special treatment have lost their toxic properties. At the same time, they retain immunogenicity - the ability to cause an immune response in the human body. Pharmacological action AS-toxoid consists of a number of reactions that occur in the body after administration of the drug:
Antitoxic antibodies continue to circulate in the blood, protecting a person, but over time their number decreases.
The vaccine is used in adults and children over seven years of age to protect against tetanus. Anatoxin is used for injuries with damage to the skin if more than 5 years have passed since the last tetanus vaccination. Emergency prevention of infection is indicated in the following cases:
The vaccine is also used every ten years, even if there was no damage. Emergency and planned prevention of infection with tetanus toxoid does not require special preparation for healthy people. In cases where the patient has acute or chronic form, you need to contact family doctor or a therapist. It defines possible contraindications to immunoprophylaxis.
AC toxoid is administered subcutaneously. One vaccination dose is 0.5 milliliters. Anatoxin, like other agents for parenteral administration, must be visually checked for the presence of foreign components, changes in color or consistency. Before performing the procedure, the health care worker performs a patient's thermometry. The injection site is treated with an antiseptic solution. The ampoule with the drug is slightly shaken. One vaccination dose is administered to one patient. The fact of immunoprophylaxis is recorded in the relevant medical documentation.
For people who have not received the DTP vaccination course, active immunization is used. It consists of a double injection of AS toxoid with an interval of 30-40 days and one revaccination a year later.
Doctor's advice. After vaccination, it is recommended to stay on the territory of the medical institution for at least half an hour. To promptly seek help in case of early post-vaccination reactions
Contraindications to immunization with tetanus toxoid are divided into absolute and relative. The first group includes allergic reactions and post-vaccination complications due to the previous administration of the drug. To the group relative contraindications includes:
In all these cases, immunoprophylaxis is carried out in usual doses no earlier than a month after achieving stable remission.
Important! Immunodeficiency conditions caused by HIV infection, taking hormonal drugs, do not interfere with the prevention of tetanus
Tetanus toxoid is a weakly reactogenic drug. Post-vaccination reactions and complications occur rarely. These include:
Very rarely, after administration of the toxoid, allergic reactions of the anaphylactic type, convulsions, and difficulty breathing occurred. If the rules of asepsis and antisepsis are violated during vaccination, complications such as post-injection abscess and regional lymphadenitis sometimes occur. If any pathological post-vaccination reaction occurs, you should consult a doctor as soon as possible. Only a specialist can correctly assess possible risks and prescribe appropriate treatment.
Treatment of post-vaccination reactions should be carried out after medical consultation and under the supervision of a doctor. Slight swelling, redness and local increase in temperature at the injection site are physiological reactions that occur with local inflammatory process. They do not require treatment and go away on their own. Other complications are treated with symptomatic therapy. When the temperature rises significantly, antipyretics are used. For allergic reactions - desensitizing and antiallergic agents. Purulent complications vaccinations - abscess and lymphadenitis, treated after consultation with a surgeon. Use antibacterial infusion therapy. In more severe cases - surgical treatment: opening and drainage of the abscess.
The drug must be stored in a dark place, out of reach of children, at a temperature of zero to eight degrees above zero. The vaccine must be transported at appropriate temperatures. The maximum shelf life of the vaccine is 3 years. A drug that has expired can be disposed of.
For immunoprophylaxis of tetanus, other drugs are used in addition to toxoid. These include:
The drug for tetanus immunoprophylaxis should be selected by the doctor individually for each patient, depending on the state of health and immune status.
Clinical contraindications to routine vaccinations with AC toxoid:
1. Acute infectious and non-infectious diseases - vaccination is carried out no earlier than one month after recovery.
2. Exacerbation of chronic diseases - vaccination is carried out in a state of clinical and laboratory remission.
3. Long and serious illnesses (viral hepatitis, tuberculosis, meningitis, myocarditis, diffuse diseases connective tissue etc.) - vaccination is carried out individually 6-12 months after recovery.
4. Severe forms allergic reactions for the administration of ADS, ADS-M, AD-M, AS-anatoxins (shock, Quincke's edema, polymorphic exudative erythema etc.).
5. Severe post-vaccination reactions in the form of anaphylactic shock, encephalitis, agranulocytosis - vaccination is carried out no earlier than 6 months after recovery (remission).
6. Hereditary and progressive neurological and joint diseases, sub- and decompensated hydrocephalus, acute disorders cerebral circulation, seizures more often than once every 6 months, epilepsy and epileptic syndrome with seizures no more than once in 6 months.
Note. Children with non-progressive cerebral palsy and other stable neurological disorders can be vaccinated with ADS-M toxoid after the age of one year; children with convulsive syndrome in history, they can be vaccinated with ADS-M toxoid 6 months after an attack against the background of anticonvulsant therapy.
7. Immunity disorders: oncological diseases, immunosuppression as a result of cytostatic therapy and the use of corticosteroids for more than 14 days. Such children can be vaccinated 1 month after discontinuation of these treatment methods.
8. Anemia: contraindications for vaccination are patients with a hemoglobin level below 80 g/l.
Vaccination with AC toxoid is carried out no earlier than 2 months after vaccination against other infections.
In each individual case of a disease that is not on the list of contraindications, the question
contraindications for vaccination are decided by the commission.
In order to identify contraindications, the doctor (federal assistant of the FAP) on the day of vaccination conducts a survey and examination of persons who are being vaccinated, with mandatory thermometry. Persons temporarily exempt from vaccinations must be supervised and registered and promptly vaccinated after the contraindications are lifted.
1. History hypersensitivity to the appropriate drug.
2. Pregnancy:
1. Active immunization
The drug is injected subcutaneously into the subscapular region. A full course of immunization with AC toxoid for adults consists of two vaccinations of 0.5 ml each with an interval of 30-40 days and revaccination after 6-12 months with the same dose. With an abbreviated schedule, the full course of immunization includes a single vaccination with AC toxoid in a double dose (1.0 ml), revaccination after 1-2 years with a dose of 0.5 ml and then every 10 years.
Immunization of some populations (elderly people, unorganized population), taking into account specific conditions in certain areas, according to the decision of the Ministry of Health of Ukraine, can be carried out according to an abbreviated scheme, providing for a single vaccination with AC toxoid in a double dose (1.0 ml) and revaccination after 1-2 years with a dose of 0.5 ml and then every 10 years.
Note;
1. Active immunization Children against tetanus aged 3 months and older are routinely treated with adsorbed diphtheria-tetanus pertussis vaccine ( DPT vaccine) or adsorbed diphtheria-tetanus toxoid (ADS-anatoxin, ADS-M-anatoxin) in accordance with the instructions for the use of drugs.
2. Revaccinations of adults previously fully immunized with associated drugs containing tetanus toxoid are carried out every 10 years with AC or ADS-M toxoids in a dose of 0.5 ml.
3. Persons who have not previously been vaccinated against tetanus (from 26 to 56 years of age) who have received a single dose of ADS-M toxoid for the prevention of diphtheria, in order to form full immunity to tetanus, 30-40 days after the administration of ADS-M toxoid, are administered AC-antoxin in a dose 0.5 ml. Revaccination is carried out after 6-12 months once with the same dose of AC toxoid.
2.Emergency prophylaxis of tetanus
Emergency prevention of tetanus includes primary surgical treatment of the wound and simultaneous specific immunoprophylaxis.
Emergency specific prophylaxis of tetanus is indicated for:
Injuries involving violation of the integrity of the skin and mucous membranes;
Frostbite and burns (thermal, chemical, radiation) of the second, third and fourth degree;
Out-of-hospital abortions;
Childbirth outside medical institutions;
Gangrene or tissue necrosis at any stage; abscesses;
Animal bites;
Penetrating injuries of the gastrointestinal tract.
For emergency specific prevention of tetanus, the following is used:
Adsorbed tetanus toxoid (AS-a);
Adsorbed diphtheria-tetanus toxoid (ADS-a) with reduced antigen content (ADS-M-a);
Anti-tetanus human immunoglobulin (ATHI), made from blood immune people. One prophylactic dose PSChI contains 250 international units (IU);
Antitetanus serum (ATS), obtained from the blood of hyperimmunized horses. One prophylactic dose of PSS is 3000 IU.
The scheme for choosing prophylactic agents during emergency specific prophylaxis of tetanus is presented in Table No. 1.
AC toxoid is injected subcutaneously into the subscapular region.
PSCH is administered in a dose of 250 IU intramuscularly into the upper outer quadrant of the buttock.
PSS is administered in a dose of 3000 IU subcutaneously.
Before administering PSS, an intradermal test with horse serum diluted 1:100 is required to determine sensitivity to horse serum proteins (the ampoule is marked in red).
To carry out an intradermal test, use an individual ampoule and a sterile syringe with graduations of 0.1 ml and a thin needle.
The diluted serum is injected intradermally into the flexor surface of the forearm in a volume of 0.1 ml. The reaction is recorded after 20 minutes. The test is considered negative if the diameter of the swelling or redness at the injection site is less than 1.0 cm. The test is considered positive if the swelling or redness reaches a diameter of 1.0 cm or more. When negative skin test PSS (from an ampoule marked in blue) is injected subcutaneously in a volume of 0.1 ml. If there is no reaction, after 30 minutes, inject the rest of the dose of serum with a sterile syringe, the ampoule with which should be stored closed with a sterile napkin.
Comment. Persons with allergic diseases and reactions to various allergens, as well as for those who have previously been administered drugs with horse serum (PSS, anti-rabies and oral and encephalic heterogeneous gamma globulins), it is recommended to administer antihistamines before administering the main dose of PSS. For persons with a positive reaction to intradermal injection of 0.1 ml of horse serum diluted 100 times, or those who had a reaction to subcutaneous injection of 0.1 ml of PSS, further administration of PSS is contraindicated.
Active routine immunization and emergency specific prevention tetanus is carried out in compliance with the following rules:
Before use, the ampoule of the drug is carefully inspected;
The drug cannot be used if there is no label on the ampoule, there are cracks in the ampoules, there are foreign inclusions, there is sediment, the expiration date has expired, or improper storage;
Immediately before administering AS-anatoxin, the ampoule is shaken until
homogeneous mixture;
Before opening, the ampoule is wiped with cotton wool moistened with alcohol before and after the cut with a file. An open ampoule with AS toxoid or PSS can be stored, covered with a sterile napkin, for 30 minutes;
The drug is drawn into a syringe from an ampoule using a long needle with a wide bore. For injection, be sure to use a new needle;
For disinfection, the skin at the injection site is wiped with cotton wool soaked in 70% alcohol. After administering the drug, the injection site is lubricated with iodine or alcohol.
Vaccinations performed are recorded in established registration forms, indicating the date of vaccination, the list of drugs administered (ADS, PSS, PSCH), doses, time of administration, series, institute-manufacturer of the drug, as well as reactions to the administered drug.
After the administration of AS-toxoid, the following may be observed: general reactions, manifested in malaise and fever, and local reactions in the form of redness, swelling, pain, which disappears after 24-48 hours. In exceptional cases, shock may develop. After administration of PSS, complications may develop: serum sickness, anaphylactic shock. In this regard, each vaccinated person must be under medical supervision for an hour after vaccination. If symptoms of shock appear, immediate anti-shock therapy is necessary. The room in which vaccination and emergency specific prophylaxis of tetanus is carried out must be equipped with anti-shock therapy.
Persons who have received PSS should be warned of the need to urgently apply for medical care in case of fever, itching and rashes on the skin, joint pain and other symptoms characteristic of serum sickness.
Self-medication can be harmful to your health.
You should consult your doctor and read the instructions before use.
