NICE urges rapid referral for suspected meningitis

Emergency hospital referral for suspected meningitis has been backed by NICE.

NICE said that children and young people with suspected meningitis or meningococcal septicaemia should be transferred to secondary care as an emergency by calling 999.

The recommendation supports HPA guidance on meningitis care. But Jane Blewitt, education and training manager at the Meningitis Trust, said NICE guidance offered welcome clarification, because it was unclear how well the HPA guidance was being followed.

NICE has also said that parenteral antibiotics should be given at the earliest opportunity, unless this would delay admission to secondary care.

The guidance includes a table listing signs and symptoms that can be used to identify possible cases.

Among the early signs and symptoms NICE lists are: cold hands and feet, fever, irritability, leg pain, lethargy, respiratory symptoms and vomiting.

NICE includes as late signs and symptoms: bulging fontanelle, clinical shock, confusion, convulsions and seizures, focal neurological signs and impaired consciousness, as well as neck stiffness, petechial rash, purpuric rash, photophobia and rapid deteroriation of condition.

Ms Blewitt said that it was crucial that healthcare professionals trusted parents' instincts regarding signs and symptoms.

'Parents know their children the best,' she said.

The draft guidance is open to consultation until 17 December.

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