1. What are the s/s meningitis in adults?
    • severe headache 90% common
    • nuchal rigidity
    • sudden high fever
    • altered mental status, confusion

    • nuchal rigidity -inability to flex neck forward passively due to increased neck muscle tone & stiffness, occurs in 70% of cases
    • photophobia (intolerance to bright light) and
    • phonophobia (intolerance to loud noises).
  2. What are the s/s meningitis in children?
    • Nery non-specific!
    • Drowsiness
    • May be irritable and looking unwell
    • Bulging of the fontanelle (up to 6 mo)
    • Leg pain, cold extremities
    • Characteristic rash

    • Rash numerous small, irregular purple or red spots ("petechiae") on the trunk, lower
    • extremities, mucous membranes, conjuctiva, It is specific for the disease;
  3. Wht are the long term consequesnces of meningitis? #3
    • deafness, epilepsy,
    • hydrocephalus and cognitive deficits,
  4. prevention
  5. Treatment of meningitis?
    • Lumbar puncture
    • Antibiotics
    • Antivirals drugs
    • Corticosteroids
  6. What is petechiae? #6
    A is a small (1-2mm) red or purple spot on the body, caused by a minor hemorrhage (broken capillary blood vessels).

    Used to refer to the smallest of the three classes of purpuric skin eruptions, those that measure less than 3 mm.
  7. What is Malaise?
    • Feeling of general discomfort or uneasiness
    • General feeling of being unwell
  8. What is the pupillary light reflex?
    • Both pupils should constrict with light shone into either eye alone.
    • Optic nerve damage
    • Oculomotor nerve damage
    • Brain stem death
    • Depressant drugs (barbiturates)
  9. Stroke Who calls neurology when stroke pt arrive?
    ED MD
  10. When do we give (protocol) Stroke medication?
    What is it?
    • MD must order Alteplase
    • Pharmacy will come to the ED to mix at bedside & give to RN
    • Must be given within < 3 hrs
    • Door to Alteplase <60 min
  11. Stroke #
  12. How do you perform swallow sceen?
    90 ml of water
  13. Misc.
    send labs withing 15 min
  14. When to realease orders for boarder pts?
    • release meds at 2 hrs
    • release everything else at 4 hrs
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