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.

If you have any suggestions for or feedback on this report, please let us know.