Meningitis

Meningitis is an infection causing inflammation of the meninges (the membrane which covers the brain and the spinal cord), and can be caused by viruses or bacteria. Meningitis is very serious. In babies and young children, death can occur in a matter of hours if left untreated. In some cases, the acute illness subsides into a persistent (chronic) state, which may lead to serious brain damage.

Important Information

• The most common and less serious form of meningitis is Viral Meningitis. Although a less severe illness it can still be very debilitating, causing headache, fever and drowsiness, very rarely this can progress to deep coma. In severe cases there may be weakness of the muscles, paralysis, speech disturbances, double vision or partial loss of the field of vision, and epileptic fits.
• Viral meningitis may be caused by a variety of viruses. Infection can be spread through coughing, sneezing, poor hygiene or sewage polluted water.
• The most serious and severe form is Bacterial Meningitis but this is less common. It is caused by several different types of bacteria, which live naturally at the back of the nose and throat in one in ten people and can be spread by close prolonged contact, through coughing, sneezing and kissing.
• Sometimes, but not always, the bacteria that cause meningitis can cause septicaemia (blood poisoning). This is a medical emergency needing urgent treatment with antibiotics. A rash of purple-red spots can appear starting anywhere as a cluster of tiny blood spots, which join to give the appearance of fresh bruises.
• Symptoms can look similar to the flu which can make identification of meningitis difficult. The symptoms listed can appear in any order over 1-2 days or in a matter for hours. Not all symptoms may be present and there may be additional symptoms.
• Signs and symptoms in older children can include the following; high temperature, vomiting and loss of appetite, diarrhoea, severe headache, stiff neck (unable to touch chin to chest), aversion to bright light, sore throat, drowsiness and listless, joint or muscle pains, stomach cramps, fits, confusion and disorientation, rash of red or purple blood spots, and change for the worse in a child who has recently had an infection.
• Signs and symptoms in babies and infants can also include the following; high temperature, vomiting and refusing feeds, high pitched moaning, whimpering, fever (possibly cold hands and feet), neck retraction with arching of back, blank staring expression, pale blotchy complexion, floppiness and lethargic, dislike of being handled, fretful, convulsions, difficult to wake, and tense/bulging of the fontanelle (soft spot on head).
• If there is a rash present it is worth trying the "glass test". This involves pressing a glass tumbler against the rash to see if the red spots disappear under pressure. The rash of meningococcal meningitis does not disappear on application of pressure.

Patient Care

1. STOP - Assess and observe scene.
2. THINK – Consider your safety and form action plan.
3. ACT – Check responsiveness, look for medical alert tag.
4. Perform a primary assessment. Make your child comfortable, lying back against pillows or cushions. Keep child cool. Call EMS, describe symptoms and say that you suspect meningitis.
5. Monitor the patient’s lifeline – ABCD’S.