Symptoms and Investigations Flashcards
What is a key symptoms in trying to decide if the patient has meningitis?
Meningism
- Photophobia
- Headache
- Meningeal irritation
What are the tests for meningeal irritation
Brudzinski sign - Leg bend on neck bend
Kernig Sign - Pain on hip flexion and knee extension
When does a non blanching rash occur?
Septicaemia with N.meningitidis
What are some other symptoms in meningitis?
Confused
Drowsy
Nause and vomiting
Fever
Bulging fontanelle
High pitched scream
What are some serious signs in babies
High pitched scream
rigid of floppy
Drowsy
What are some serious signs in kids/adults
Cold peripheries
Severe leg pain
Cyanosis
What is the initial investigation?
ABCDE
What is the gold standard and what are the problems?
LP but this is contraindicated in:
Raised ICP
Local sepsis
coagulopathy
Seizures
Shock
This means it may have to be delayed - therefore start treament based on clinical suspicion
what are the initial investigations?
FBC, U+Es
Glucose
Cultures
N.meningitis PCR
Coag
Cultutre
What do you need to ensure on first presentation?
the patient is not in shock. IF they are 20ml/kg fluid
Check via:
HR
BP
Peripheral pulses
Urine output
N.B pulonary oedema in management
What needs to be stable for a LP?
Neurology -
Alert, no convulsions or fits
What blood gas is done in suspected meningitis
Capillary
