OSCE Management Stuff

Question 1

What antibiotics do you give before transfer to hospital in suspected bacterial meningitis/meningococcal sepsis?

Answer 1

IV or IM ceftriaxone or benzylpenicillin

Question 2

How quickly should lumbar puncture be performed when patient arrives at hospital?

Answer 2

Within 1 hour

Question 3

Should antibiotics be given before or after lumbar puncture?

Answer 3

After if clinically safe to do so and no significant delay

Question 4

What other tests should be done for bacterial meningitis?

Answer 4

Bloods (lots)
Blood cultures
Bacterial throat swab specifying looking for meningococci

Question 5

When would you do neuroimaging before lumbar puncture?

Answer 5

If signs of SOL
OR
Signs of raised ICP (focal neurological features incl seizures/posturing, abnormal pupillary reaction, GCS <9,

Question 6

Empirical meningitis abx

Answer 6

Ceftriaxone
+/- amoxicillin if risk of listeria