Physiotherapy of Tetanus
Report:
Sinus tachycardia
Movement artefact (middle strip)
Comment:
The QRSs can be mapped out throughout the period of vibration physiotherapy - a familiar artefact in all the ICU units. A tetanic spasm would not be very different, but the patient should be free of those while in the ICU. Physiotherapists can deliver vibration at a remarkably fast rate.
The tracings illustrate an important method of dealing with hypotensive episodes during tetanus. Any physical stimulation - moving the limbs, suctioning, or physiotherapy - tends to restore the BP towards normal; at times, indeed, it may trigger a hypertensive response. Physical manœuvres are preferable to drugs as the initial therapy for dips in blood pressure. Unstable blood pressure is due to autonomic dysfunction in tetanus205.
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