This is a life threatening paediatric emergency.
The cardinal feature of meningococcal septicaemia is a purpuric rash in an ill child. Initially the rash may not be obvious and a careful search should be made. In about 13% of patients there is a non blanching erythrematous rash, while in about 7% there is no rash. The symptoms may be vary vague and non specific and include, not being themselves, off feeds, irritable, headache, neckache and lethargy.
The management priorities are as follows:
- Airway
- Breathing
Give O2 in high concentration
- Circulation
IV access (or intraosseous)
Blood culture
Fluid Bolus 10mls/kg Normal Saline
- Antibiotics Cefotaxime 50 mg/kg IV over 10 - 15 mins, IO or IM
- Hypoglycaemia 10% Glucose 5ml/kg IV (<3.3mmol/l)
- If shocked, give further fluid boluses at 10mls/kg
- Call the ED Senior, Paediatric Registrar and ITU Registrar