PDF(Pubmed)
Abstract：
BACKGROUND: The Leicester Royal Infirmary Emergency Department is one of the largest single-site Emergency Departments in the UK. We evaluated the department\'s management of bacterial meningitis. The current national guideline recommends that all patients presenting with suspected bacterial meningitis receive antibiotics within one hour.
METHODS: A survey of 100 clinicians (Consultants, Registrars, House Officers, and Advanced Clinical Practitioners) working in the Emergency Department was performed to determine the awareness of the guidelines and a retrospective examination of case notes for patients who presented at the Leicester Royal Infirmary Emergency Department with suspected meningitis was carried out between May 1, 2022, and May 1, 2023. A random sample of 30 patients was drawn from the department\'s database of 190 patients, identified through discharge coding summaries.
RESULTS: Nine (25%) of the prescribers knew of the guidelines for managing meningitis, and six (16.7%) had utilised the hospital guidelines. Thirty-three (91.7%) prescribers acknowledged the importance of administering steroids to patients suspected of having bacterial meningitis (excluding those displaying signs of meningococcal sepsis, such as a rash). However, only seven (23%) of patients received this treatment. Additionally, only one (3.3%) patient was documented as having received a dose within the first hour of presentation.
CONCLUSIONS: The timely diagnosis and administration of appropriate antibiotic therapy are pivotal elements in managing bacterial meningitis. As a result, we designed a checklist to facilitate the effective management of meningitis within the department by increasing awareness of the guidelines and making the critical principles of suspected meningitis management more accessible.
METHODS: A survey of 100 clinicians (Consultants, Registrars, House Officers, and Advanced Clinical Practitioners) working in the Emergency Department was performed to determine the awareness of the guidelines and a retrospective examination of case notes for patients who presented at the Leicester Royal Infirmary Emergency Department with suspected meningitis was carried out between May 1, 2022, and May 1, 2023. A random sample of 30 patients was drawn from the department\'s database of 190 patients, identified through discharge coding summaries.
RESULTS: Nine (25%) of the prescribers knew of the guidelines for managing meningitis, and six (16.7%) had utilised the hospital guidelines. Thirty-three (91.7%) prescribers acknowledged the importance of administering steroids to patients suspected of having bacterial meningitis (excluding those displaying signs of meningococcal sepsis, such as a rash). However, only seven (23%) of patients received this treatment. Additionally, only one (3.3%) patient was documented as having received a dose within the first hour of presentation.
CONCLUSIONS: The timely diagnosis and administration of appropriate antibiotic therapy are pivotal elements in managing bacterial meningitis. As a result, we designed a checklist to facilitate the effective management of meningitis within the department by increasing awareness of the guidelines and making the critical principles of suspected meningitis management more accessible.
摘要：
背景：莱斯特皇家医院急诊科是英国最大的单站点急诊科之一。我们评估了部门对细菌性脑膜炎的管理。当前的国家指南建议所有疑似细菌性脑膜炎的患者在一小时内接受抗生素治疗。
方法：对100名临床医生的调查(顾问，注册商,众议院官员,和高级临床从业人员）在急诊科工作，以确定对指南的认识，并在2022年5月1日至2023年5月1日期间对在莱斯特皇家医院急诊科就诊的疑似脑膜炎患者进行了病例记录的回顾性检查。从该部门190名患者的数据库中抽取了30名患者的随机样本，通过出院编码摘要识别。
结果：9名（25%）的处方者知道治疗脑膜炎的指南，6人(16.7%)使用了医院指南。33名（91.7％）的处方医生承认对怀疑患有细菌性脑膜炎的患者（不包括那些表现出脑膜炎球菌性败血症迹象的患者，如皮疹)。然而,只有7例(23%)患者接受了这种治疗.此外,据记录,只有1例(3.3%)患者在就诊后的第1小时内接受了剂量治疗.
结论：及时诊断和给予适当的抗生素治疗是治疗细菌性脑膜炎的关键因素。因此,我们设计了一份检查表，通过提高对指南的认识，并使可疑脑膜炎管理的关键原则更容易获得，从而促进部门内脑膜炎的有效管理。
方法：对100名临床医生的调查(顾问，注册商,众议院官员,和高级临床从业人员）在急诊科工作，以确定对指南的认识，并在2022年5月1日至2023年5月1日期间对在莱斯特皇家医院急诊科就诊的疑似脑膜炎患者进行了病例记录的回顾性检查。从该部门190名患者的数据库中抽取了30名患者的随机样本，通过出院编码摘要识别。
结果：9名（25%）的处方者知道治疗脑膜炎的指南，6人(16.7%)使用了医院指南。33名（91.7％）的处方医生承认对怀疑患有细菌性脑膜炎的患者（不包括那些表现出脑膜炎球菌性败血症迹象的患者，如皮疹)。然而,只有7例(23%)患者接受了这种治疗.此外,据记录,只有1例(3.3%)患者在就诊后的第1小时内接受了剂量治疗.
结论：及时诊断和给予适当的抗生素治疗是治疗细菌性脑膜炎的关键因素。因此,我们设计了一份检查表，通过提高对指南的认识，并使可疑脑膜炎管理的关键原则更容易获得，从而促进部门内脑膜炎的有效管理。
