The Republican. [volume] (Oakland, Md.) 1877-current, 1929-07-04
30 OF 43 TETANUS CASES IN
MARYLAND WE'RE FATAL
State Health Department Gives
Out Statistics for 1928

counties and q in Baltimore City. Of
the cases in the counties, 4 were in
the age group from 5 to 9 years; 10
in the age group from II to Is years
and 8 in the groups over II years of
age. Of the q cases in Baltimore
City, 16 terminated fatally; IA of the
% cases in the counties terminated
fatally.
Perhaps the most important point
in the care of tetanus is the treat
ment of the initial wound, and the
prophylactic use of anti-tetanus SER
UNI. This is especially to be remem-
| bered in the treatment of wounds re-
ceived from fre-crackers and blank
cartridges, such as are used on the
Fourth of July. The wound should be
thoroughly opened and cauterized,
either with an actual cauter or with
Tuning nitric acid, and then it should
be kept open, in order that any
bacillus with Judgment in the wound
may be exposed to the air, which is
fatal to its life. The individual should
then receive Immediately, as an initial
dose, from 1900 to 5000 units of
antitetanus serum injected into the
muscles.
Tetanus anti-toxin is a specific and
trustworthy preventative. The pro-
phylactic dose is from 1900 to 5000
units. The rule is to give a prophy-
Tactic dose in all cases where there is
danger of this complication, especial
ly if the wound is lacerated or pune
tured If the wound contains necrotic
| tissue or foreign body, the injec-
ton should be repeated every seven
days until the wound is clean or so
long as the hazard persists. 1t is
important to remember that tetanus
anti-toxin is eliminated OF destroyed
in the body in the course of ten days
or two weeks. This makes it neces-
sary to repeat the injection weekly in
order to continue the immunity until
the danger is past.
Wounds from fire-crackers and fire
arms are especially dangerous and
likely to occur at this season, but
punctured and lacerated wounds
caused by nails and by injuries due to
automobile accidents may happen at
any time and should receive prophy-
Tactic treatment promptly whenever
they do occur.
Even when tetanus anti-toxin has
been administered at the time of the
primary injury, cases of so-called
posteric tetanus have occurred at a
later period.
To avoid the danger of hypersensi-
tiveness, the patient should first be
given a simultaneous injection of 0.5
&C of serum diluted with 0.5 &C. of
salt solution, followed after five min
utes by second simultaneous dose
of 1 &C. of serum and Is minutes
later by a third simultaneous dose of
5 C. c. of serum. One hour later the
intravenous injection of the full dose
should be begun. Injection should be
made slowly and the serum should be
warm at the time of injection.
AS soon as a patient with developed
tetanus is seen he should be given
5000 units of anti-tetanus serum into
the spinal canal, 5000 units into mus
cles, and 10000 units into the vein
This may be repeated from twelve to
twenty-four hours after, according to
the necessity of the case. Keen, in
his treatise on "The Treatment of
War Wounds" says zone should ex-
pect tetanus in all wounds and pre-
vent its onset"
Fear of anaphylaxis should never
prevent the use Of serum when indi-
Gated. Careful technic and slow adj
ministration will go far to avoid SER
ious accidents of this nature.
Increase in Deaths From Automo.
bile Accidents
One hundred and thirty-two per
sons have been killed in automobile
accidents in Maryland during the first
five months of 1929. For the same
period of last year such accidents
caused 116 deaths.
The death rate in Maryland due
to automobile accidents has increased
from or per 100000 population il
1910 to 21.5 in 1928. The rate was
POT in 1927, 1877 in 1926, ia in 1925
and 1862 in 1924.
Motor vehicle deaths occur witt
much greater frequency during tht
second six months of the year. Thi'
is due largely to the fact that auto
! mobiles are in much greater use dur
ing the summer and fall months.
About twenty-five percent of thu
, deaths from automobile accidents il
Maryland occur among children unde
: fifteen years of age. Parents shoult
be urged to take special precaution
for the protection of their children
: from such accidents during the vaca
ton period, as it is during thes