As part of its regular learning and development initiatives (LDI) for external stakeholders, the Research Institute for Tropical Medicine (RITM) through its Nursing Department capacitated 446 nurses nationwide through its free Snake Bite and Tetanus Management training via Zoom on May 24, 2023.
The training’s objectives include the following:
- increase nurses’s knowledge on proper management of snake bite cases according to snake bite categorization;
- cascade updates on snake bite management, especially administration of antivenom, management of likely adverse reactions, and the antivenom extraction process;
- explain the sources of tetanus and how tetanus spreads to humans and environment;
- help nurses recognize clinical symptoms of tetanus infection and risk factors; and
- provide sufficient information on tetanus prevention, especially vaccination, wound care, and immunoglobulin injection.
“This webinar activity aims to impart our (Nursing Department’s) expertise, share our knowledge and experiences not only within the premises of RITM and our own nurses, but to make it available to you and other areas wherein it is especially needed as well, and to make sure that we are helping you as best as we can,” said Nurse V and Nursing Department LDI Chairperson Myrna Cirila Acero.
The training featured the Institute’s very own Nursing Supervisors Evelinda Guevara and Larredo Azores, who discussed tetanus management and snake bite management respectively. Before the training proper, participants were asked to answer a pre-test. This was shortly followed by Guevara’s presentation.
The lecture on tetanus management covered the following topics: staging and categorization of tetanus infections, clinical signs and symptoms, criteria for hospital admission of tetanus cases, tetanus scoring and monitoring, and laboratory procedures for tetanus cases, therapeutic management, and supportive management of tetanus patients.
Tetanus, a known disease affecting the nervous system, is caused by the Clostriduim tetani bacteria. When the causative bacteria enters the body, a toxin is produced that causes painful muscle contractions – a prevalent manifestation of tetanus infection. One can be infected by tetanus through exposure to the bacteria’s spores.
Guevara shared some specific tetanus management tips which include the following:
- Admit tetanus patient to an area with minimal auditory, visual, and tactile stimuli;
- Implement pulmonary hygiene; gently suction secretions using aseptic technique;
- Clean and dress tracheostomy site on a daily basis;
- Turn patient side to side every two (2) hours especially sedated or paralyzed patients to avoid bed sores; and
- Debride wounds if necessary
After the tetanus management lecture, Azores’ snake bite management lecture proceeded. The lecture discussed snake bite prevention, classification of snake bite infections according to toxicity, first aid for snake bites, nursing responsibility, the Philippine Cobra Antivenin (PCAV), and supportive management for snake bite patients.
Azores explained that snake bite infections are primarily classified as neurotoxic and hemotoxic. Neurotoxic snake bites, which are delivered by cobras, target the central and peripheral nervous system. Neurotoxins from cobras in turn paralyze respiratory functions of the body. Meanwhile, hemotoxic snake bites derived from viper snakes, directly affect red blood cells and disrupt coagulation of the blood. Therefore, damaging tissues and contributing eventual organ degeneration/failure. Azores also reminded nurses that despite the fact that not all snakes are venomous, it is recommended to consider that all snakes carry potential harm to human health.
“This webinar has been an outstanding example of how to deal with your current practice in the hospital. Your mind has been fed with a torrent of thoughts, information, and vision that can be useful reference to your standard,” said Chief Nurse Lorela Mendoza as she closed the training session.
Upon completion of the training and accomplishment of necessary activities (accomplishment of pre-registration and online attendance forms, pre-test, post-test, and training evaluation), all registered nurses who participated earned 2.5 continuing professional development (CPD) points.
The RITM Nursing Department will once again conduct a training for nurses this November that will focus on management of sexually transmitted infections (STIs).
by Anel Azel Dimaano