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Discussion

Possible Menengitis

Hello everyone,

I was wondering if anyone has experienced a similar occurrence. I am an RN on a medical floor and got a patient that was elderly who apparently was very independent and then in a matter of hours staff found her unresponsive. EMS brought her in through the ED and gave her the admitting dx of UTI/change in mental status. Pt had a hx of dementia, cva, lots of cardiac issues.... Pt would not open her eyes on exam. They were so tightly clenched i could not even manually open them to check her pupils. Pt had a pettechial rash mostly around her mouth. Pt could not really verbalize anything- just moaning groaning looking very restless. Pt had been on IV Mirem for about 24 hours. ID doctor came in at the end of my shift and alluded the patient might possibly have meningitis- but family not wanting a LP. I was using standard precautions my whole shift and am concerned about the possibility of contracting. I attempted to suction her once with the yankauer but she clenched her mouth. Has anyone ever had a situation like this? Its not like EH is passing out cipro because there is no definitive diagnosis....

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    Oops spelled meningitis wrong....

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    • Admin

    If the patient had received medications for 24 hours, isolation precautions can be discontinued:

    The Centers for Disease Control and Prevention (CDC) recommends droplet precautions in addition to Standard Precautions for bacterial meningitis caused by either N. meningitidis or H. influenzae. Precautions may be discontinued 24 hours after initiation of effective therapy. When droplet precautions are initiated, the risk for transmission is much lower. The local health department should be notified to arrange for follow-up of household and community contacts.

    From: Meningitis: Bacterial vs. Viral on ADVANCE for Nurses

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