A ten year review of the mortality among tetanus patients admitted to the intensive care unit at Kenyatta National Hospital, Nairobi

Abstract

A ten year retrospective study, running from 1980 to 1989; both years included, was undertaken at the Kenyatta National Hospital (K.N.H). This study was undertaken to find the mortality and assess the management of the patients admitted" to the intensive care unit with tetanus. A total of 90 files, out of the expected 115 (78.3%) were studied. The rest of the files were not traced.

The patients were all cases of tetanus, admitted and managed in the intensive care unit (I.C.U). Their ages ranged from one year to seventy three years. An in-patient number was obtained from the I.C.U admission records. The number was then used to trace the file in the records department. Each file was then scrutinised carefully for the appropriate details which were noted on a data collection sheet. Following admission to the I.C.U. most of the patients were managed in the same way using the Total paralysis Regime (T.P.R). Wound debridement was done where necessary, then tetanus toxoid (0.5 mls intra muscular stat) or Anti-tetanus serum (ATS'10000 to 15000 I.U; LM.stat) was given. Sedation was undertaken either with diazepam (mainly), phenobarbitone or in a few instances, chlorpromazine (largactil). Some patients were known epileptics and therefore they required phenytoin.