Table 2 Ablett Classification of the Severity of Tetanus [16]

I

Mild

Mild to moderate trismus; general spasticity; no respiratory embarrassment; no spasms; little or no dysphagia

II

Moderate

Moderate trismus; well-marked rigidity; mild to moderate but short spasms; moderate respiratory embarrassment with an increased respiratory rate > 30, mild dysphagia

III

Severe

Severe trismus; generalized spasticity; reflex prolonged spasms; respiratory rate > 40; apnoeic spells, severe dysphagia; tachycardia > 120

IV

Very severe

Grade III and violent autonomic disturbances involving the cardiovascular system. Severe hypertension and tachycardia alternating with relative hypotension and bradycardia, either of which may be persistent.