a child with painful muscle spasmNew Year’s Eve is being celebrated worldwide. Partying and noisemaking with firecrackers and fireworks are common elements of this occasion. If in other countries there are public displays of fireworks organized by city governments or private corporations, in the Philippines almost each household lights up firecrackers to welcome the New Year. it is a tradition that was passed to us by the Chinese.  It is originally meant to drive away bad spirits and bring good luck to the family. Accidents occur most of the time with firecracker usage. Despite the annual campaign by the Department of Health Filipinos could not completely veer away from using firecrackers. As of January 3, 2011 the reported casualty after the New Year celebration reached 794. it was even higher by 8% from last year’s statistics. This includes firecracker-related injuries, injuries due to stray bullet and firecracker ingestion.Firecracker-related injuries, just like any other injuries presenting with open wounds could be contaminated. Patients with these kinds of wounds can therefore contract tetanus.

What is tetanus?

        Tetanus is a medical condition affecting the nervous system. it is characterized by a prolonged and painful contraction of skeletal muscle fibers. the primary symptoms are caused by tetanospasmin, a neurotoxin produced by the Gram-positive, obligate anaerobic bacterium Clostridium tetani. Infection generally occurs through wound contamination and often involves a cut or deep puncture wound. As the infection progresses, muscle spasms develop in the jaw (thus the name “lockjaw”) and elsewhere in the body. It can interfere with the ability to breathe and, ultimately, threaten the life of the patient.

The bacteria that cause tetanus, Clostridium tetani, are found in soil, dust and animal feces. It is an anaerobic bacterium, meaning it and its endospores survive well in an environment that lacks oxygen. Tetanus begins when spores of Clostridium tetani enter damaged tissue. the spores transform into rod-shaped bacteria and produce the neurotoxin tetanospasmin.

Mortality rates reported vary from 48% to 73%. In recent years, approximately 11% of reported tetanus cases have been fatal. the highest mortality rates are in unvaccinated people and people over 60 years of age.

The incubation period of tetanus ( the time before the signs and symptoms appear)  may be up to several months but is usually about 8 days. In general, the further the injury site is from the central nervous system, the longer the incubation period; the shorter the incubation period, the more severe the symptoms.

Tetanus cases can also develop from the following types of injuries: puncture wounds (including from splinters, body piercings, tattoos, injection drugs), gunshot wounds, compound fractures, crush injuries, burns, surgical wounds, ear infections, dental infections, animal bites, infected foot ulcers in people with diabetes, infected umbilical stumps in newborns born of inadequately immunized mothers.

Common signs and symptoms of tetanus, in order of appearance, are spasms and stiffness in your jaw muscles, stiffness of your neck muscles, difficulty swallowing, stiffness of your abdominal muscles, painful body spasms, lasting for several minutes, typically triggered by minor occurrences, such as a draft, loud noise, physical touch or light. Other signs and symptoms may include fever, sweating, elevated blood pressure and rapid heart rate.TreatmentCleaning the wound is essential to preventing growth of tetanus spores. This involves removing dirt, foreign objects and dead tissue from the wound.  your doctor may give you a tetanus antitoxin, such as human tetanus immune globulin.  Antibiotics are usually given, either orally or by injection, to fight tetanus bacteria In order to prevent future tetanus infection the patient needs to receive tetanus vaccine as well.  Doctors generally use powerful sedatives to control muscle spasms. Severe cases of tetanus require admission to intensive care units for supportive management in ventilation and nutrition.

If you have lost a loved one through medical negligence, such as your son or daughter through blood poisoning, then you should think about consulting a medical negligence solicitor.

In his early twenties your son was a young man. when he stayed in bed late one morning, it wasn’t usual. he was active and sporty. he had plenty of friends with a good social life and career prospects.

Something was wrong. he was in bed with a raging temperature, complaining of terrible pain.

You rang the doctor’s surgery and asked to be put through to your doctor on the phone.

After a minute the receptionist’s reply came back informing you the doctor had said it was probably a fever and to get him to drink plenty of fluids and rest. you called again half an hour later as this was clearly not the solution. This seemed like a nightmare of medical negligence. His condition deteriorated and he was getting worse. he was sweating and weak.

You called the surgery again but were told to take him to casualty or wait for the home visiting doctor on his daily rounds. you felt as if you were being a nuisance.

You called an ambulance. two days later, your son died of meningococcal septicaemia. you believe that you have experienced medical negligence. you feel angry and betrayed and want an explanation. Had the doctor responded earlier he could have been saved.

After the inquest, the thought persists that this must be a case to take to a medical negligence lawyer. Surely this area of law covers refusal to attend someone who is so ill and gets a dismissal of symptoms? The hospital were brilliant, they did all they could to save him but it was too late. Is medical negligence still applicable in this case, applied to the GP, rather than the hospital?

A medical negligence solicitor will help to support you to find out. he will go through the history, the medical notes and call in an independent medical doctor to study the case in fine detail. a medical negligence claim is very rarely a short process and therefore you must be aware that whilst you are feeling your grief you will have to deal with long and complicated communications and likely court action. Making a claim against your doctor will not bring your loved ones back to you, but it might help stop mistakes like what happend to your family to anyone else.

MANILA, Philippines – At least 891 people were injured by firecrackers and stray bullets during the New Year revelry, the Department of Health said Monday.

Based on the latest DOH data, 844 people were injured by firecrackers, 36 were hit by stray bullets and 11 were hurt after ingesting firecrackers.

The casualty count is 13% lower than last year’s total of 1,028 casualties, according to Dr. Eric Tayag of the DOH’s National Epidemiology Center.

Tayag said the leading cause of injuries is piccolo, followed by kwitis and 5-star.

He said most of the victims waited for 5 days before going to the hospital for treatment.

The DOH is now on tetanus alert in anticipation of the surge of complications from untreated firecracker injuries. Tayag said they are treating all victims of firecrackers as serious cases.

Manifestations of tetanus come out as early as 3 days to one month. Among the symptoms of tetanus are headache,lockjaw, high fever and weakness.

"Yung mga galing na sa ospital na naputukan dapat nyong tiyakin na nabigyan kayo ng anti tetanus na bakuna. Kung wala, kailangan niyong bumalik," he said.