The plan for managing patients with tetanus has three features: immunization, diagnosis, and sedation. Their effectiveness is shown by experience with 17 patients over a period of 7 years. The mortality was 17%, which is lower than the national average of 40 %. As soon as tetanus is suspected, an anesthesiologist is requested to begin sedation by large doses of short-acting barbiturates injected intramuscularly at six-hour intervals. Promethazine hydrochloride is given intramuscularly midway between the barbiturate injections to reduce the anxiety of the patient. A prophylactic tracheotomy is performed under local anesthesia, and a supportive program is then started. The sedation is maintained in order to prevent convulsions with apnea; while it continues, the patient must be turned every two hours to prevent decubitus ulcers and hypostatic pneumonia. After the initial critical period of 7 to 10 days, oral medication generally becomes possible.