Emergency Presentations Flashcards
1
Q
How does meningitis present?
A
- Drowsiness. floppyness, N+V, off feeds, confusion, irritability
- Photophobia
- Seizure
2
Q
What are some of the signs of paeds meningitis?
A
- Bulging fontanelle <18 months
- Neck stiffness
- +ve Kernig and brudzinkski sign
- Focal neurological signs/ papillodema
3
Q
How is meningitis investigated?
A
- A- E
- Bloods: FBC, UE. CRP, glucose, clotting
- ABG
- LOC assessment
- LP
4
Q
What are the CI to LP?
A
- Infection at LP site
- Signs of raised ICP
- Signs of cardiorespiratory instability
- Post seizure
- Focal neurological signs
- Concerns about meningococcal septicaemia
5
Q
What is the mx of bacterial meningitis?
A
<28 days: cefotaxime, amoxicillin + gent
>28 days: cefotaxime + amoxicillin
If > 3 months steroids: dex.
Duration depends on the bacterial agent
N. meningitis - 7 days
H influenzae: 10 days
Strep pneumoniae/ GBS: 14 days
E. Coli/ listeria: 21 days
6
Q
What other treatment considerations are important for meningitis?
A
- Steroids < 3months prevents hearing loss
- IV fluids: normal saline.
- CT scan
- Hearing test within 6 weeks
7
Q
What are some of the acute and long term complications of meningitis?
A
- Acute: septic shock, DIC, Raised ICP, SIADH, hydrocephalus. cerebral abscess
- Long term: hearing loss,vasculitis, subdural effusiion, infarctiom. learning difficulties
