Pre-hospital assessment and treatment of meningococcal meningitis

Despite the development of vaccines which have substantially reduced the acquisition of some strains of meningitis (McIntyre et al, 2012), bacterial meningitis maims or kills approximately 20% of people that contract the disease (van de Beek et al, 2012), and is, therefore, a medical emergency in which the patient requires immediate medical intervention. There are approximately 3 200 cases of bacterial meningitis and septicaemia in the UK and Ireland annually, of which meningococcal infection is the most common (Meningitis Research Foundation, 2014a). As the patient's deterioration in health can often be rapid and unpredictable (Weisfelt et al, 2008), this has serious implications for ambulance clinicians in recognising and treating community-acquired meningococcal meningitis.

Because bacterial meningitis is life-threatening, early diagnosis and treatment is vital (Brouwer et al, 2012)—the necessity of which is underlined in a study that demonstrated an association between increased three-month mortality in patients and delayed antibiotic treatment of three hours or more post-hospital admission (Auburtin et al, 2006). Research has suggested that there is also an incremental effect of delay in treatment on the rate of mortality: the greater the delay, the greater the mortality rate (Proulx et al, 2005).