How To Prevent Tetanus After July Fourth Accident
( Originally Published 1936 )
The modern Fourth of July is a convincing example that unnecessary accidental destruction of life can be prevented by the marshalling of public opinion. We can believe that the dreadful death toll from automobile accidents in our own day is capable of reduction.
Just think. In 1903 there were 4,449 Fourth of July injuries sufficiently grave to be reported, in the United States. Of these 415 developed lockjaw, 406 of whom died.
I can remember well that the great excitement on the fifth of July was to read in the morning paper how many casualties there had been. There was the local list of casualties and the national list—given city by city, state by state. An expected death rate! For no good reason.
The reform that has occurred was accomplished in the face of interested manufacturers and importers of firecrackers and fireworks, and despite the protests of free born citizens who guarded their in-alienable right to blow their own fingers off, and over lamentations about the decay of patriotism. So there is hope we may be able to do something about the automobile death rate and prohibition.
Some celebration of the event still occurs. Vigilance must not be relaxed. The danger is less but lockjaw is still possible and this article is written as a reminder.
The most convincing set of figures ever collected on the subject of the prevention of tetanus, or lockjaw, by tetanus anti-toxin, are those of the experience in civil practice in the United States in Fourth of July injuries. For comparison let us put it down in tabular form:
FOURTH OF JULY INJURIES IN THE UNITED STATES
Year. Total injured. Cases of tetanus. Deaths from tetanus.
1903 ........................... 4449 415 406
1906 ........................... 5466 89 75
1910 ........................... 2923 72 67
1913 ........................... 1163 4 3
About 1903 the American Medical Association started a campaign to educate the public and the medical profession to the necessity for treating all wounds by the administration of tetanus anti-toxin. The results are evident. In three years the incidence of tetanus developing in Fourth of July wounds fell from nine and a fraction to one and a fraction per cent. It is a convincing argument for public education in health matters.
The administration of tetanus serum should be given in all open wounds, with any possibility of contamination by street dirt. It should be done as soon as possible after the injury—minutes count.
The question arises, is there any harm in the administration of tetanus serum? The answer is that almost always a week later the patient has a severe case of hives for a day or two. To people sensitive to horse serum more serious symptoms develop. But to balance this, remember that tetanus once developed kills in nearly 100 per cent of cases.