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.
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 – 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
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?)
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)