MENINGITIS

& Headaches

What is meningitis?

Swelling (-itis) of the lining surrounding the brain & spinal cord (meninges)

Life-threatening condition ~135,000 deaths each year

(globally) Usually affects kids & young people (but not always)

What is meningitis?

Usually viral or bacterial (bacterial more serious)

Septicaemia is the poisoning of the blood which may occur alongside meningitis

Affects 3,200 in UKevery year

What is meningitis?

Even when the disease is diagnosed early and adequate treatment is started, 5% to 10% of patients die, typically within 24 to 48 hours after the onset of symptoms. Left untreated, up to 50% of cases may die. Bacterial meningitis may also result in brain damage, hearing loss or a learning disability in 10% to 20% of survivors.

It’s up to us…

Need to recognise symptoms early and get the patient to hospital urgently

Symptoms?

What are the early symptoms? Rash? NO Fever Vomitting Headache ‘Feeling unwell’

Symptoms?

What else could there be? Muscle/joint/limb pain Cold hands & feet Pale or blotchy skin (+ blue lips)

Symptoms?

What are the late symptoms? Drowsiness Confusion Rapid R.R. / S.O.B Stiff neck Photophobia Rash Seizures

Rash

Not always present! Red & blotchy Could be anywhere What’s special about it?

Rash – Tumbler test

Does not fade or change colour when you place a glass against it = suspect meningitis

Assessment & Management

Primary survey Airway – swollen? Noisy? Etc. Breathing – fast or slow? Circulation – poor circulation? Dysfunction – may be affected Expose – if there’s a rash, find it!

Tumbler test Obs (response, pulse, resp rate, cap refil) SAMPLE (esp history of symptoms) 999 early!!

Headaches

What else could cause headaches?

Headaches

Tension headaches Migraines CVA (stroke) & TIA Raised intracranial pressure (head

injury) Sinusitis etc.

Migraines

True or false – Migraines can come with… Intolerance of light/sound? Vomiting? Pins and needles?

Patients usually know they get migraines

Often preceded by an ‘aura’

Raised ICP

Increased pressure within skull Caused by tumours, abscesses &

haematomas Need to go to hospital S&S:

Generalised headache Gradual increase in severity Vomiting Temporary visual loss

CVA (Stroke)

Caused by blood clot or bleed in the brain

FAST positive? S&S (Sudden…):

Weakness (FAST) Visual disturbance Severe headache Dizziness Confusion

What is a T.I.A?

Headache Assessment

ABCs Obs S – other symptoms?

Nausea, vomiting, one-sided weakness, confusion, drowsiness, loss of consciousness etc.

FAST test!! Allergies Medications Past medical history

Hyptertension = higher risk of CVA (stroke) Susceptible to migraines? Family history?

Last meal Event history

Previous head injury? (days before?)

Pain Assessment

(In addition to primary survey, obs, SAMPLE)

O P Q R S T

Seizures (‘Fits’)

There are many types and causes (inc Epilepsy and increased temperature)

Management: Remove dangerous/ harmful objects DO NOT restrain the patient TIME the fit

If first fit or >5mins call 999 Recovery position after the fit has subsided Cover the patient with a blanket in case

the wet themselves (DIGNITY)

More Info

http://www.meningitis.org/symptoms