From 25 to 30-foot falls to concussions, broken bones and stitches, this week’s blog is about another emergency situation that most parents face at one time or another. The short falls from bicycles, swings, playing hard and running into walls, slides, skating rinks, swimming pool edges and stumbles on sidewalks can be just as hard on the noggin as the big falls. Concrete, wall and hard ground meets a child’s head and there is bound to be a gash or split skin that will require stitches.
On Route to the hospital
So, it’s off to the emergency room. On your way there, be sure to give your child (and yourself) some Aconite to handle the shock and potential for swelling internally within the head. And let the gash bleed…profusely. This is the best way to keep the area clean until you can get to the hospital where emergency staff will ‘debride’ (clean up) the wound, especially if it was more than just concrete your child was in contact with (e.g. road rash incurred during skateboarding in the spring before road clean up!).
What the medical staff are most concerned about at this stage, is any exposure to the tetanus bacteria. The only way it can enter the body in a way that is potentially harmful to children and adults is through open wounds. This bacterium loves an anaerobic environment (meaning no oxygen). If you are keeping the wound open to the air (oxygen) and bleeding, there is a much better chance that the bacteria cannot take hold.
The Big Wait
So, there you are waiting, waiting, waiting in the ‘waiting’ room, you and your child well splotched with blood by now and it occurs to you, the ‘question’ from the doctors and/or nurses. It’s routine and they are going to ask it…the vaccination question.
Maybe you have already avoided calling the grandparents because of the ‘V’ issue; the issue is what the situation can possibly become, especially with something as serious as tetanus.
And it is serious, tetanus and the ‘V’ question. Being prepared ahead of time for this question/conversation is important. You might be very fortunate if the emergency staff are respectful of your choices, especially when they take the time to understand that you have made an informed choice.
Please remember…some emergency medical staff see the worst of the worst…including the effects of a tetanus infection. Parents have also reported though, that their emergency room experience was less than kind.
Be prepared.
The Medical Choices
You take the deep breath, decide honesty is the best policy, and in reply to the ‘question’ you say, ‘my child is vaccine free’. You will likely be advised at this point to have your child vaccinated with a tetanus vaccine and/or to have your child given an injection of ‘tetanus immune globulin’.
Before respectfully declining the vaccine, do ask the doctor sincerely, if tetanus is a real risk at this point. If the wound has been cleaned well and the doctor assesses a low-risk situation, then you can rest in your choice if you are quite familiar with the risks of the tetanus vaccine.
Here is what one parent wrote to me about tetanus, vaccines and their recent family trip to emergency for stitches:
“I feel the more people that are aware the better. I think tetanus is a frightening situation for parents because the only information that we get from doctors is to get the vaccines. Even our pediatrician said to me that he couldn’t possibly do his own research on all the vaccines out there.” – AK
With just a little bit of research, what you will discover is that a tetanus vaccine after the injury will have no effect in preventing tetanus in a vaccine free child or adult.
From the National Vaccine Information Center ‘Tetanus Quick Facts’ (print a copy to have on hand if you go to the Emergency Department of a hospital):
“According to the CDC, common tetanus vaccine reactions include injection-site redness, pain, and swelling at the injection site. However, if the pain and swelling are significant and extend from the shoulder to the elbow, the CDC warns that additional tetanus toxoid vaccine doses should not be administered more frequently than every ten years. 15 Additional serious reported side effects following tetanus toxoid vaccination include anaphylaxis,16 17 brachial neuritis,18 Guillain-Barre Syndrome (GBS),19 20 acute disseminated encephalomyelitis (ADEM),21 arthritis,22 23 and myocarditis.24”
Onto option number two…the ‘tetanus immune globulin’ or ‘TIG’.
What is TIG?
TIG is the plasma from the blood pooled from a number of people vaccinated for tetanus, then ‘washed’, filtered and then packaged. It is then given as an injection through the muscle rather than through a vein.
This too has risks, the biggest one being that this is a blood product with the real possibility of contamination. As much care is taken to be contaminate-free, tainted blood products are all too real. Know the risks.
Benefits and Risks: Vaccine and TIG
And here is what the same parent sent to me in follow up regarding their choice to refuse both the vaccine and TIG:
“When our child got his stitches out the pediatrician stated that the TIG shot is a blood product and should only be given to someone who is at risk. He asked if the doctors at the hospital said anything about the TIG shot to us. Then he went on to say that if they did not discuss it then they would have felt our child was not at risk for tetanus. He (the pediatrician) was wary of the blood product only because of possible transmission of other diseases, saying that it is not 100% safe. Even though they screen, the blood stuff may still get through. After I heard that I was actually more confident that I did the right thing.” – AK
From Drugs.com product monograph with the product name HyperTET (the PDF of the product monograph is available at this link:
Risk of Transmissible Agents in Plasma-derived Preparations
Because TIG is prepared from pooled human plasma, it may carry a risk of transmitting infectious agents, including the causative agents of viral hepatitis and HIV infection, and theoretically may carry a risk of transmitting the causative agent of Creutzfeldt-Jakob disease (CJD) or variant CJD (vCJD).
Improved donor screening, viral-inactivation procedures (e.g., solvent/detergent treatment), and/or filtration procedures have reduced, but not completely eliminated, risk of pathogen transmission with plasma-derived preparations.
The manufacturing process for TIG includes certain chemical (solvent/detergent) treatment procedures and/or heat-treatment procedures to reduce viral infectious potential.
Because no purification method has been shown to be totally effective in removing the risk of viral infectivity from plasma-derived preparations and because new blood-borne viruses or other disease agents may emerge which may not be inactivated by the manufacturing process or the chemical (solvent/detergent) treatment procedures currently used, administer TIG only when a benefit is expected.”
And do visit the National Vaccine Information Centre website where you can find the very best, up to date information on vaccine safety in general and this link in particular, for Tetanus.
Homeopathic remedies for tetanus risk
You can use homeopathy to help support the body heal from deep and superficial puncture wounds along with Arnica and/or Aconite for the shock that can come when you or a loved one has a significant gash or puncture wound.
Arnica montana
Common Name – Leopard’s Bane
One of the main characteristic symptoms of Arnica is ‘Says he/she is well when very ill or sick’. In a case of a head wound or any deep wound anywhere, you might look at them and go ugh…that is a big gash. And they say to you, ‘Oh I am fine. I don’t need to go to the emergency.’ That is the time for Arnica. Injuries or concussions are a good indication for Arnica as well, with any bruising or swelling.
If the situation is such that you have been in a car accident and you are also in a state where you are ‘feeling fine’ but look at your arm and see that you in fact, have a rather deep wound, take Arnica. Arnica will help with the shock of the incident.
Aconitum napellus – Aconite
Common Name – Monkshood
Aconite is very useful for sudden injuries with shock and fear. The person needing Aconite might even ask if they are going to die, such is the fear.
Ledum
Common Name – Labrador Tea
Ledum is one of your first go-to remedies for puncture wounds, cuts, scrapes, insect bites (think ticks and Lyme disease) where there could be a risk of infection.
Ledum together with Hypericum, is well known to be the homeopathic first aid for tetanus prevention. Tetanus spores need an anaerobic (no oxygen) environment to grow so stopping the bleeding unnaturally, covering the injury up before making sure it is clean will create the perfect opportunity for tetanus to be a concern. Let the cut or puncture wound bleed naturally, keep it clean and expose the injury to air (oxygen).
Hypericum perforatum
Common Name – St. John’s Wort
Meet Ledum’s partner in first aid injuries that involve the nerves and also for tetanus prevention. Sometimes called the ‘Arnica of the nerves’, this is a remedy you will use often.
Similar to Ledum, there is an affinity for puncture wounds, bites (this is the tetanus prevention part) of insects and animals. In first aid situations, you might need to change remedies as needed. E.g. Ledum to start with the puncture wound but once the shock wears off, the nerve pain becomes more prominent. Then switch to Hypericum.
What about our animals?
For the pet owners, farmers, ranchers and animal lovers, the indications for using homeopathic remedies for mammals are the same as for humans for possible tetanus infection. Clostridium tetani can infect through open wounds, especially if the wounds do not bleed or if the wound closes over too quickly, which creates the anaerobic environment that C. tetani needs to multiply.
If your beloved animal has a puncture wound and you suspect the possibility of infection, give Ledum. And if the nerves are affected, give Hypericum.
Yours in health and healing,
Donna
