Tetanus

ʻO Tetanus kahi maʻi o ka ʻōnaehana hopohopo me kahi ʻano bacteria e make make paha, i kapa ʻia ʻO Clostridium tetani (C tetani).

Nā spores o ka maʻi koʻohuneC tetani i loaʻa i loko o ka lepo, a i loko o nā holoholona feces a me ka waha (gastrointestinal tract). I ka palapala spore, C tetani hiki ke noho mau i ka lepo. Akā hiki ke hoʻomau i ka maʻi maʻi ma mua o 40 mau makahiki.

Hiki iā ʻoe ke loaʻa i ka maʻi tetanus ke komo nā spore i kou kino ma o kahi ʻeha a ʻeha paha. Lilo i nā spores i nā koʻohune hana i hohola i loko o ke kino a hana i kahi lāʻau make i kapa ʻia he tetanus toxin (ʻo ia hoʻi ʻo tetanospasmin). Paʻa kēia lāʻau make i nā hōʻailona nerve mai kou iwikuamoʻo i kou mau mākala, e hoʻoulu ai i nā spasms mākala koʻikoʻi. Hiki i nā spasms ke mana loa a haehae lākou i nā mākala a i ʻole ke kumu o ka haki o ka iwi kuamoʻo.

ʻO ka manawa ma waena o ka maʻi a me ka hōʻailona mua o nā hōʻailona ma kahi o 7 a 21 mau lā. ʻO ka hapa nui o nā hihia o tetanus ma ʻAmelika Hui Pū ʻIa ke kū nei i kēlā mau mea ʻaʻole i pale pono ʻia i ka lāʻau.

Hoʻomaka pinepine ʻo Tetanus me nā spasms akahai i nā iwi ā (lockjaw). Hiki i nā spasms ke hoʻopili i kou umauma, ʻāʻī, hoʻi, a me nā mākala ʻōpū. Hoʻokomo pinepine ka spasms muscle i hope i ka arching, i kapa ʻia ʻo opisthotonos.

I kekahi manawa, hoʻopili ka spasms i nā mākala e kōkua i ka hanu ʻana, a hiki i nā pilikia hanu.

Hoʻolālā ka muscular hoʻolōʻihi i ka hopena o ka hopena, ikaika, a ʻeha hoʻi o nā pūʻulu muscle. Kapa ʻia kēia inoa ʻo tetany. ʻO kēia nā ʻāpana e hiki ai ke hōʻeha i nā haki a me nā waimaka o nā mākala.

ʻO nā ʻōuli ʻē aʻe e like me:

• Drooling
• Nui ka hou ʻana i ka hou
• Fiva
• Pākuʻi lima a wāwae paha
• Huhū
• Pahu i ka paʻakikī
• ʻO ka urination kāohi ʻole a i ʻole ka hoʻohaʻahaʻa

E hana ana kāu kauka i kahi hoʻokolohua kino a nīnau e pili ana i kāu moʻolelo olakino. ʻAʻole loaʻa kahi hoʻokolohua hoʻokolohua kikoʻī e ʻike pono i ka tetanus.

Hiki ke hoʻohana ʻia nā hoʻāʻo e kāpae i ka meningitis, rabies, lāʻau strychnine, a me nā maʻi ʻē aʻe me nā ʻōuli like.

Hiki ke hoʻopili ʻia i ka mālama ʻana:

• Nā Antibiotics
• Wahi moe me kahi ʻano mālie (kukui uila, hoʻemi i ke kani, a me ka mahana paʻa)
• Lapaʻau e hoʻopilikia i ka lāʻau make (tetanus immune globulin)
• Hoʻomaha nāʻiʻo, e like me diazepam
• Nā sedatives
• ʻOki kino e hoʻomaʻemaʻe i ka ʻeha a hemo i ke kumu o ka lāʻau make (debridement)

ʻO ke kākoʻo hanu me ka oxygen, kahi pahu hanu, a me kahi mīkini hanu e pono ai.

Me ka mālama ʻole ʻia, make ʻo 1 o ka 4 poʻe maʻi. ʻOi aku ka kiʻekiʻe o ka make no nā keiki hānau hou me nā tetanus i lapaʻau ʻole ʻia. Me ka lapaʻau kūpono, ma lalo o 15% o ka poʻe i loaʻa i ka maʻi i make.

ʻOi aku ka makaʻu ma ke poʻo a me ka maka ma mua o nā mea ma nā ʻāpana ʻē aʻe o ke kino. Inā ola ke kanaka i ka maʻi maʻi, pau ka hoʻōla. ʻO nā hanana i hoʻoponopono ʻole ʻia o ka hypoxia (ka nele o ka oxygen) i hoʻokumu ʻia e nā spasms muscle ma ka ʻāʻī e alakaʻi i ka ʻino o ka lolo i hiki ʻole ke hoʻi.

Nā hopena e hopena ʻia mai ka tetanus me:

• Pāpale alanui
• Hopu paʻa hanu
• Hewa puʻuwai
• Pulumonia
• Poino i nā mākala
• Nā haki
• Poino lolo ma muli o ka nele o ka oxygen i ka wā spasms

Kāhea koke aku i kāu kahu mālama inā loaʻa iā ʻoe kahi ʻeha hāmama, keu hoʻi inā:

• Ua ʻeha ʻoe ma waho.
• Ua pili ka ʻeha me ka lepo.
• ʻAʻole i loaʻa iā ʻoe kahi booster tetanus (vaccine) i loko o 10 mau makahiki a i ʻole ʻaʻole ʻoe e ʻike i ke kūlana o kāu lāʻau āpau.

Kāhea i kahi manawa me kāu mea hāʻawi inā ʻaʻole ʻoe i pale ʻia i ka tetanus ma ke ʻano he makua a keiki paha. Kāhea aku nō hoʻi inā ʻaʻole i pale ʻia kāu mau keiki, a inā ʻaʻole maopopo ʻole iā ʻoe ke ʻano o ka pale ʻana o ka tetanus (vaccine).

IMMUNIZATION

Hiki ke pale ʻia ʻo Tetanus e ka pale ʻana (vaccine). Pale mau ka pale ʻana i ka maʻi tetanus no 10 mau makahiki.

Ma ʻAmelika Hui Pū ʻIa, hoʻomaka nā pale ʻana i ka wā kamaliʻi me nā kiʻi DTaP o nā pū. ʻO ka lāʻau DTaP kahi lāʻau lapaʻau 3-in-1 e pale aku ai i ka diphtheria, pertussis, a me ka tetanus.

Hoʻohana ʻia ka lāʻau lapaʻau Tdap a i ʻole lāʻau lapaʻau Tdap e mālama ai i ka pale ʻana i ka poʻe i piha ka makahiki 7 a ʻoi. Hāʻawi ʻia kahi lāʻau lapaʻau Tdap i hoʻokahi manawa, ma mua o ka makahiki 65, i mea pani no Td no ka poʻe i loaʻa ʻole ka Tdap. Paipai ʻia nā mea hoʻonui Td i kēlā me kēia 10 mau makahiki e hoʻomaka ana i ka makahiki 19.

ʻO nā ʻōpio ʻōpio a me nā mākua i loaʻa nā ʻeha, ʻo ia hoʻi nā ʻeha puncture, pono e loaʻa kahi booster tetanus inā ʻoi aku ma mua o 10 mau makahiki mai ka booster hope loa.

Inā ua ʻeha ʻoe ma waho a i ʻole kekahi ʻano e launa pū ai me ka lepo, e hoʻopili aku i kāu mea hoʻolako e pili ana i kāu makaʻu e loaʻa i kahi maʻi tetanus. Pono e hoʻomaʻemaʻe koke ʻia nā ʻeha a me nā ʻeha. Inā make ke kino o ka ʻeha, pono i kahi kauka e wehe i ka ʻaʻa.

Ua lohe paha ʻoe hiki iā ʻoe ke loaʻa i ke tetanus inā ʻeha ʻoe i kahi kui kuʻi. ʻOiaʻiʻo wale nō inā haumia ke kui a loaʻa ka maʻi koʻohune tetanus ma luna. ʻO ka lepo ia ma ke kui, ʻaʻole ka popo e hāpai i ka makaʻu no ka tetanus.

Lockjaw; ʻO Trismus

• ʻO bacteria

Birch TB, Bleck TP. ʻO Tetanus (Clostridium tetani). I: Bennett JE, Dolin R, Blaser MJ, hua pā. ʻO Mandell, Douglas, a me Bennett's Principle a me ka hoʻomaʻamaʻa ʻana i nā maʻi kūpilikiʻi. 9th ed. Piladelapia, PA: Elsevier; 2020: chap 244.

ʻO Simon BC, Hern HG. Nā loina hoʻokele eha. I: Nā paia RM, Hockberger RS, Gausche-Hill M, nā ʻaoʻao. ʻO Rosen's Emergency Medicine: Nā Manaʻo Manaʻo a me ka hana lapaʻau. 9th ed. Piladelapia, PA: Elsevier; 2018: chap 52.