Karen Lynn Vidra, The Texas Tornado, click
here to update your pages on AuthorsDen.
Paramedic Stories XVIII: Tetanus! (By Kendall V. Smith, Paramedic/EMT) (Part One) by Karen Lynn Vidra, The Texas Tornado
Wednesday, October 27, 2004
Rated "PG" by the Author.
The paramedics respond to an unusual but terrifying case.
I don't think I shall ever forget what we witnessed two weeks ago as long as I shall live and breathe. I saw something that still chills me to the bone today, and until we met this particular woman, I had never seen a disease like tetanus in a person.
We had studied about it in EMT/Paramedic Training; but until I saw Tashi Tachingwe, I had never witnessed it.
The woman in question was originally from Nigeria, in Africa (in fact, she still LIVED there; she was in the United States, visiting some friends here in Nashville) when she first took sick. She had inadvertantly stepped on a dirty, rusty nail with her foot, and she never even thought of it until a few days later, when her foot started hurting. She started complaining of increasing pain in her foot, which was, by now, infected, and as time went on, the pain spread throughout her body; and a few days later, she started having painful spasms rippling throughout her entire body, spasms that would manifest themselves with any little noise, touch, or movement. Her entire body would shake, and you could see the spasms rippling beneath her thin, sweat-soaked skin; and her face would go into a horrible grimace, to where it appeared that she was smiling; but she was not smiling. Her back muscles would tense up so much, her back would arch severely, to the point to where only her head and feet were resting on the bed while the rest of her body was raised into the air. The spasm was causing the muscles in her face to contract; and you could see the pain and terror in her half-closed eyes. Her body was riddled with the overwhelming tetanus infection, and unless some quick, lifesaving medical intervention was warrented, this young woman didn't have a prayer or a chance at surviving the deadly illness that was now invading her body.
When we got to the scene, we immediately put the semi-unconscious woman onto a stretcher and started an I.V. into one arm; and hooked her up to a heart monitor and gave her oxygen via nasal cannula. We also monitored her vital signs and found that the woman was clearly in shock and in danger of dying. We placed her into the rear of the ambulance and started treating her symptoms as best as we could; but every so often we would have to stop as the woman would go into yet another full-blown seizure coupled with contractions that twisted her thin body into horrible positions. We knew we had to get her to an emergency facility fast if she was to have any chance of survival. The toxin that was flowing through her body was caused by a cut on her foot, which was infected (we discovered this problem upon examination); and she was now in a very critical state of affairs.
To be continued~
_______________________________________
Author's Notes:
Tetanus (also known more commonly as "lockjaw") is a disease in which a "toxin" produced by the anaerobic bacterium "clostridium tetani" causes severe (and painful) muscle spasms.
Rare in the U.S. (about 100 cases of tetanus are reported in the U.S. annually), but common in other parts of the world, especially in developing countries, as many as 50,000 people die worldwide every year from tetanus. Spores of clostridium tetani can live for YEARS in soil or animal feces. It can get into a person's body via an opening (such as a wound or cut), where they then germinate (grow). Only growing tetanus baciili produces the toxin, not the bacteria themselves. This is what causes the disease known as tetanus, or "lockjaw".
It can sometimes develop when cuts come in contact with dirty, rusty objects, or deep puncture wounds from stepping on a nail or other sharp object, especially if the object is dirty. It can also result from clean, superficial wounds. In the U.S., injecting drug users, people who have surgical wounds from surgery, or people with burns are particularly at high risk in developing tetanus. After childbirth, tetanus infection of the woman's uterus and the umbilical stump of the newborn infant can also happen--an ongoing hazard in developing, or "third world" countries.
~Symptoms of tetanus/lockjaw:
*restlessness;
*stiffness of jaw, arms, neck, legs;
*difficulty in swallowing or breathing;
*irritability;
*fever, headache, chills, sore throat;
*muscle spasms in neck, arms, legs, jaw, face, throughout rest of body as disease progresses;
*facial muscle spasms cause a "fixated smile", spasms of back, stomach, and neck produce patients going into a "bowed" position (known as "opistachomos"), where the back is arched off the bed; but the back of the head and the back of the feet are on the bed;
*heightened awareness of noise, movement, people bumping into the bed, lights, or drafts, which can then send the person into the painful opistachomic position; can also cause profuse sweating or painful muscle spasms, which, in turn, prevents normal breathing as the lungs then lock up.
Worldwide mortality rate of tetanus: as high as 50% of all cases (half of those afflicted) will die of tetanus every year.
Treatment of tetanus/lockjaw:
~person is immediately hospitalized, kept in quiet, darkened room, often in Intensive Care unit, where they can be treated and closely monitored;
~antibiotics are given by I.V., also given tetanus-immune globulin to neutralize the toxin. Given Valium or other means of sedation to relax muscles, relieve pain, control the seizures, also controls the heart rate and blood pressure;
~Ventilator or other means of oxygen delivery is sometimes given if the person is having a lot of difficulty with their breathing;
~Nourishment is given via a nasogastric (NG) tube in the nose, down the throat, and to the stomach and also by I.V.;
~Person, upon recovery (that is, if they survive the disease) has to have another tetanus shot after survival to prevent reacurrance of the disease. The next time they may not be as fortunate.
~Tetanus is serious business; it is NOTHING to be taken lightly!~
A unique story but not unusaul because most para-medics have just about seen it all if they stay at it for long. The picture was heart wrenching. Powerful write.
GAD what a picture! sad what people in third world countries have to endure, diseases that very seldom are seen here in america...diseases that were (mostly) eradicated...that has GOT to be a horrible way to die. makes me hurt looking at the graphic *ow*
and what a terrifying write--can't wait to read more about tashi.
Spoken Word
This CD will touch the deepest inner part of your humanness and spirit, you will never be the same after listening to the depths of struggle, the reality of life, the touching voice of truth. It will shock you, move you to tears. It w
A poignant story about letting go of a narcissist in your life. Have you ever been attacked FULL force by a narcissist? It's the closest thing to being stabbed over and over in the back.
Suspenseful and close to home, Rain of Deception 2 will leave you in Tears. Much like Part 1, this will shocking sequel will keep you on the edge of your fingertips.
I don't think I shall ever forget what we witnessed two weeks ago as long as I shall live and breathe. I saw something that still chills me to the bone today, and until we met this particular woman, I had never seen a disease like tetanus in a person.
