Table 2:

Ablett classification of severity of tetanus

Grade	Clinical features
I	Mild: mild to moderate trismus; general spasticity; no respiratory embarrassment [respiratory distress]; 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 greater than 30 [breaths/min]; mild dysphagia
III	Severe: severe trismus; generalized spasticity; reflex prolonged spasms; increased respiratory rate greater than 40 [breaths/min]; apneic spells; severe dysphagia; tachycardia greater than 120 [beats/min]
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

Reproduced from Cook TM, Protheroe RT, Handel JM. Tetanus: a review of the literature. Br J Anaesth 2001;87:477–87 by permission of Oxford University Press.³