Prehospital Management Essay

1475 Words 6 Pages
Over the last decade, monumental advances in the medical field have taken place, resulting in prompt recognition and management of many diseases. Despite this, meningococcal disease remains one of the leading causes of death in children and young people worldwide (Dowson, 2014). With its rapid onset and serious nature, meningococcal septicaemia affects up to 0.95% of the western world’s population each year making it essential for health professionals to understand the pathophysiology, recognition and treatment of this deadly disease in the prehospital setting.
This essay will be divided into two parts: the first will examine the prehospital management of an unconscious patient presenting with advanced meningococcal septicaemia; the second
…show more content…
This series of events leads to intravascular thrombosis, where micro clots form in the smaller blood vessels, causing further inadequate perfusion and worsening of ischaemia. These clots form widespread purpura fulminans, best described as the tiny blood spots and discoloration of the skin in patients infected with the meningococcal bacteria (Heyderman, 1993). As these micro clots form, clotting factors become exhausted leading to thrombocytopenia. With a reduced amount of platelets and clotting factors in the blood, the body recognises it has overcompensated and begins to break down the already formed clots. Disseminating intravascular coagulation results, where widespread bleeding occurs internally and externally, effectively worsening hypotension, decreasing perfusion, and contributing to multiple organ failure (Manchanda, Gupta, & Bhalla, …show more content…
Meningitidis, there is a strong need for the use of antibiotics. St John ambulance protocols (2014) has listed the treatment of Meningococcal septicaemia under the sepsis section, where the choice of antibiotic listed is Ceftriaxone. For an adult patient suspected of having this disease, 2g via the intravenous route regardless of distance from hospital in indicated. Paediatric patients suffering from the same condition require reduced dose due to their smaller stature. Using the same mixed volume, the intravenous dose for these patients is 0.04g per kilo of weight. If intravenous access cannot be obtained in either age group, 2ml of 0.9% normal saline or 1% lignocaine is to be added to each of the two ampules, with half the respected dose being administered intramuscularly into each thigh. Despite the use of Ceftriaxone among NZ ambulances, the use of alternative antibiotics, such as Benzylpenicillin is hugely popular in the United Kingdom ambulance sector. The Ambulance Service Association for the United Kingdom advocates Benzylpenicillin use in patients presenting with Meningococcal septicaemia, with the standard dose for an adult patient being two 600mg vials each dissolved in 9.6ml of sterile water given intravenously over 2-3 minutes. Both Ceftriaxone and Benzylpenicillin are broad spectrum antibiotics, and when compared, the differences in mechanism of action and possible side effects are minimal (Lehne, 2013).

Related Documents