In today’s First Aid article, we discuss Meningitis and Septicaemia.
Both are equally serious illnesses that can lead to a casualty becoming very ill, very quickly. Regrettably, in some cases, these illnesses can lead to death.
It is because of the seriousness of both these illnesses that I must stress the need to trust your gut instinct and always err on the side of caution if you suspect a person may have either meningitis or Septicaemia.
So what is Meningitis?
Meningitis is a swelling of the meninges, three thin layers that surround the brain and spinal cord. It can be caused by bacteria, viruses, and in some cases fungi entering the body.
Contrary to some beliefs Meningitis can strike at any age but newborn babies are most at risk because their immune system is not yet fully developed. Babies under the age of 3 months are 70 times more likely to get bacterial Meningitis than adults are. Toddlers are the next highest risk group followed by teenagers.
Bacterial Meningitis: This is the most serious type of Meningitis and the World Health organisation states if left untreated 50% of casualties will die and 10-20% of bacterial Meningitis cases leave severe long-term effects. The disease is most often caused by meningococcal bacteria, which live in the back of our throat and nose. This is most often spread by coughing, sneezing, and breathing the same air as someone who is carrying the germ. One in ten people can carry this germ and are asymptomatic, not even realising they have the germ themselves, but thankfully for the vast majority of us, this germ is harmless to us because we have built up a natural resistance to it.
Viral Meningitis: Viral Meningitis is rarely life-threatening. It is mainly caused by enteroviruses most often in Summer and Autumn. It is spread mainly by hand-to-mouth transmission. Most people who contract viral meningitis recover with no side effects however recent studies have shown that some patients may develop short-term memory loss and attention deficit.
How can I tell if it’s bacterial or viral meningitis? The simple answer is you can’t. The doctors in the hospital will do a lumbar puncture and recover a sample of Cerebral Spinal Fluid and send it for analysis to a lab straight away. While the sample is being analysed the doctors will most probably begin an appropriate broad-spectrum antibiotic treatment immediately.
What are the Signs and Symptoms of Meningitis?
The most important message here is that a patient does not need to have all of the following signs or symptoms to have a positive diagnosis of Meningitis. The signs and symptoms of meningitis in their early stages are quite common in other illnesses too and are often misdiagnosed at first as the flu, a viral infection of no immediate danger, or even a bad hangover in older patients. This disease tends to peak in the Autumn for older kids as they return to school and begin to mix. In third-level colleges, students often begin to increase their alcohol intake which is disinhibitive and they mix more freely among their peers spending more time in each other’s company.
Having just one of the following sings and symptoms may cause you concern that a child is ill or is becoming ill. Having several of the signs and symptoms noted below should really raise alarm bells and you should act immediately.
Remember, trust your gut instinct and if you are concerned at any point seek immediate help from a healthcare professional.
* Fever and vomiting
* Severe headache
* A stiff neck
* A dislike of bright lights
* Confused or delirious
* Very sleepy, vacant, or difficult to wake up
* A rash anywhere on the body
Please note that a rash does not always occur in these illnesses so we should never wait for one to appear before we consider either Meningitis or Septicaemia.
Septicaemia is the medical term for blood poisoning caused by the same germs that cause Meningitis. Once these germs enter the bloodstream they multiply rapidly and this can lead to sepsis, a potentially fatal reaction to the infection. Sepsis causes inflammation throughout the body and can lead to blood clots and oxygen being blocked from reaching vital organs.
The National Institute of Health in America states that 28-50% of those who get severe sepsis will die from the condition
Septicaemia is most commonly acquired in hospitals following surgery especially if you have had a catheter or IV inserted. Other causes include pneumonia, open wounds, burns, urinary tract infections, or if you have a weak immune system.
What are the signs and symptoms of Septicaemia?
* Fever or vomiting
* Limb, joint, and muscle pain sometimes accompanied by stomach pain or diarrhea
* Cold hands and/or feet.
* Pale or mottled skin
* Breathing fast or breathlessness
* Confused or delirious
* Very sleepy, vacant, or difficult to wake
* A rash anywhere on the body
What are the warning signs in babies that we need to be aware of?
* A tense or bulging Fontanel (The soft spot on the babies head)
* Unusual grunting sounds
* Irritable when picked up with a high pitched cry
* A stiff body with jerky movements or a baby who is floppy and lifeless
* Cold hands and feet
* Vomiting or refusing to feed
* Pin prick rash/marks or purple bruises anywhere on the body
* Pain/ irritability from muscle aches or limb/joint pain
What is the tumbler test?
When and if a rash develops due to Meningitis or Septicaemia we are encouraged to get a clear glass and press down firmly on the rash. If the rash does not blanch or disappear then this is considered a positive sign of Meningitis or Septicaemia and we must seek help immediately. On dark skin, the rash is more difficult to spot so always check the palms of the hands, the souls of the feet, inside the eyelids, or the roof of the mouth. The rash is often a late-stage sign and is a result of blood leaking from the blood vessels into the tissue under the skin. Check for tiny red or brown pin-prick marks which change into purple blotches or blood blisters.
What are the side effects of these diseases?
Some people will, unfortunately, die as a result of these terrible diseases. Some will make a full recovery and show no outward sign of ever having contracting these diseases. And others will be left with a lifetime of physical and mental impairment including:
• Brain injury, Cerebral Palsy, and Epilepsy
• Blindness/ Vision loss
• Speech problems
• Organ damage
• Scarring/ Skin damage
• Weakness/ paralysis or spasms
• Clumsiness or poor coordination
Remember you know your child best, always seek help if you suspect Meningitis or Septicaemia. Even with the best intentions in the world, doctors can misdiagnose an illness in its early stages, so therefore even if we have sought advice we should always seek further advice if
1. You feel your child’s condition has deteriorated after seeing your doctor.
2. You are more worried about your child now than when you previously sought advice
3. You are concerned that you are unable to look after your child
Finally, I would encourage anyone who has an interest in this topic to visit the excellent Meningitis Research Foundation website where you will find lots of information on these illnesses and what steps we can take to avoid them.
Next week we will discuss choking, and when and how to intervene.
Aiden Thompson is a PHECC registered paramedic and former Search And Rescue winchman with the Irish Coastguard helicopter, R118, based in Sligo. As a PHECC registered first aid instructor and an Irish Heart Foundation training site coordinator Aiden delivers the highest standard of training to members of the public.
If you would like any further information on courses available in your area, please contact Aiden on 0863111661 or visit his website www.dsts.ie for further details.