Perawatan pasien dengan penyakit Tetanus yang menjalani perawatan di ruang Intensif
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- DOI: https://doi.org/10.15562/medicina.v52i1.1045 |
- Published: 2021-04-01
Open Access & Peer Reviewed
Multidisciplinary Medical Journal
Multidisciplinary Medical Journal
Abstract
Tetanus is caused by the neurotoxins released by clostridium tetani which are anaerobic bacteria. Tetanospasmin enters the wound, spreading centrally along the motor nerve to the spinal cord or entering the systemic circulation to reach the central nervous system. External stimulation, including sudden exposure to bright light, can trigger general skeletal muscle spasms, can also cause inadequate ventilation so that it can cause death. A 63-year-old man weighing 60 kilograms with a diagnosis of Generalized Tetanus, came still unconscious with injuries to the foot after being hit by a tractor engine, 2 weeks before entering the hospital. The patient complained of shortness of breath since 7 days, pain in the legs, fever, stiffness in the facial muscles, and said to have experienced seizures. During observation in the emergency room, the patient experiences seizures, and loss of consciousness, then the patient is given airway management, and intubation and treatment are carried out in the Intensive Room. The patient was treated for a total of 13 days in the Intensive Room. Tetanus, very challenging and has high mortality rate, but with good airway treatment, seizure management, and good nutrition, patient has good chance for recover.
Tetanus disebabkan oleh neurotoksin yang dilepaskan oleh Clostridium tetani yang merupakan bakteri anaerob. Tetanospasmin masuk dalam luka, menyebar secara terpusat di sepanjang saraf motorik ke sumsum tulang belakang atau memasuki sirkulasi sistemik untuk mencapai sistem saraf pusat. Stimulasi eksternal, termasuk paparan sinar terang yang tiba – tiba, dapat memicu kejang otot skeletal umum, dapat juga menyebabkan ventilasi tidak adekuat sehingga dapat menyebabkan kematian. Seorang lelaki usia 63 tahun dengan berat badan 60 kilogram dengan diagnosis Tetanus Generalisata, datang masih sadar dengan luka pada kaki setelah terkena mesin traktor, 2 minggu sebelum masuk Rumah Sakit. Pasien mengeluh sesak nafas sejak 7 hari, nyeri pada kaki, demam kekakuan pada otot wajah, serta dikatakan pernah mengalami kejang. Selama observasi di ruang gawat darurat, pasien mengalami kejang, dan penurunan kesadaran, lalu pasien diberikan tata laksana jalan nafas, dan dilakukan intubasi dan perawatan di ruang Intensif. Pasien dirawat total selama 13 hari di ruang Intensif. Pasien berhasil dilakukan manajemen perawatan yang baik selama di ruang Intensif dan berhasil pindah ke ruang perawatan biasa. Perawatan pasien dengan infeksi tetanus sangat menantang dan memiliki resiko kematian yang tinggi, namun dengan perawatan yang baik dalam tatalaksana jalan nafas, penanganan kejang dan nutrisi yang baik, pasien memiliki peluang untuk sembuh.
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How to Cite
Tjung, H., & Aryabiantara, I. W. (2021). Perawatan pasien dengan penyakit Tetanus yang menjalani perawatan di ruang Intensif. Medicina, 52(1), 36–38. https://doi.org/10.15562/medicina.v52i1.1045
