Guidelines for the Early Clinical and Public Health Management of ...

Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease)
12. REASSESS CLINICALLY Monitor blood glucose and assess need for
dextrose
Hypoglycaemia should be treated with 5ml/
kg of 10% dextrose solution and subsequent
inclusion of dextrose in maintenance fluids
Assess K+ needs as soon as U&E results
available
Maintain glucose
≥ lower limit of normal, but
< 10 mmol/L.
Maintain K+ within normal
range
13. IF MENINGOCOCCAL INFECTION
SUSPECTED OBTAIN THROAT SWAB
and/or PERNASAL SWAB
14. CONSIDER FURTHER
CONSULTATION
For epidemiological purposes
Important as may be only site to yield isolate,
especially, if antibiotics have been given.
Throat swab - a full sweep of the pharyngeal
wall and tonsils, from all patients. If not
possible, obtain a pernasal swab rotated on the
posterior pharyngeal wall
Microbiology, neurology, nephrology, infectious
diseases input may be helpful. Early orthopaedic
input if required (for fasciotomy), plastic surgery
if required
Monitor epidemiology
of bacterial sepsis and
meningitis.
Of critical importance in era
of introduction of ‘meningitis
vaccines’
15. NOTIFY PUBLIC HEALTH AND
INFECTION CONTROL as soon as
possible
Ensure Contact Chemoprophylaxis if
necessary (See Chapter 7, 8, 9, Appendix
4) and information as per agreed
protocol.
Under the statutory Infectious Diseases Regulations 1981, amended 2003, cases
or suspect cases of bacterial meningitis or meningococcal septicaemia must
be notified immediately to the Department of Public Health (Medical Officer of
Health). Telephone notification should be used initially, as a matter of urgency.
This is the responsibility of the admitting team. All telephone notifications must
be followed by written notification.
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