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Early diagnosis vital to tackle meningitis

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Early diagnosis is vital to reducing mortality in children and young people who contract invasive meningococcal disease (IMD), says UK clinical guidance that outlines the key symptoms nurses should look for.

Guidelines, published last week by the Scottish Intercollegiate Guidelines Network (SIGN), warn IMD can be very difficult to detect as the symptoms are very similar to that of the common cold or flu.

Up to 10% of children who contract the disease will die, according to SIGN, with most deaths occurring within the first 24 hours before the child receives specialist care.

The guideline is the broadest evidence-based review of IMD to date. It provides guidance on how primary care nurses can distinguish between meningitis and less harmful viral illnesses.

Children with meningitis will present with fever and vomiting, but they will also have neck stiffness and photophobia, it states. Septicaemia, which could be confused with meningitis, includes fever and a petechial rash as symptoms.

The guidance recommends the use of antibiotics as soon as meningococcal disease is suspected and administration of rapid IV fluids once the child is admitted to hospital.

Because IMD can kill in under four hours, it also highlights the importance of communication between primary and acute care, and paediatric ICU to ensure rapid escalation of treatment in the early phases of the disease.

Kerry Ross, Scotland community services nurse for the Meningitis Trust charity, said: ‘This guideline should be the first point of call when making a clinical judgement about IMD.

‘Meningitis can progress rapidly so early specialist care is vital – the quicker it is implemented, the better the chances of survival,’ she said.

‘The guideline also provides important information on follow-up care to help limit the damage done to affected children, who can suffer neurological damage, psychosocial problems and loss of limbs,’ she added.

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