TY - JOUR T1 - Prospective study of "door to needle time" in meningococcal disease. JF - Journal of Accident & Emergency Medicine JO - Arch Emerg Med SP - 249 LP - 251 DO - 10.1136/emj.15.4.249 VL - 15 IS - 4 AU - F A Riordan AU - A P Thomson AU - J A Sills AU - C A Hart Y1 - 1998/07/01 UR - http://emj.bmj.com/content/15/4/249.abstract N2 - OBJECTIVE: To measure the promptness of antibiotic treatment in children with meningococcal disease. METHODS: "Door to needle time" for parenteral antibiotics in children with meningococcal disease was recorded prospectively as part of a larger study. The time from arrival at hospital until the first dose of parenteral antibiotics was recorded in 100 children with meningococcal disease (median (range) age 21 (3-168) months) admitted to four Merseyside hospitals. RESULTS: Forty five children presented directly to the accident and emergency (A&E) department. Parenteral penicillin was given before admission to 19 of the 55 children referred by general practitioners (GPs). Median door to needle time was 36 minutes. All children with a typical petechial rash on arrival received antibiotics within 60 minutes. Antibiotics were given sooner to those with severe disease (p = 0.01) and later to those without a rash (p = 0.007). CONCLUSIONS: The first dose of parenteral antibiotics for most children with meningococcal disease was given in A&E. When awareness of meningococcal disease is heightened by ongoing research, those with a petechial rash are treated within 60 minutes. Strategies to improve immediate treatment of meningococcal disease should include education of A&E staff as well as GPs. ER -