RT Journal Article
SR Electronic
T1 Prospective study of "door to needle time" in meningococcal disease.
JF Journal of Accident & Emergency Medicine
JO Arch Emerg Med
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 249
OP 251
DO 10.1136/emj.15.4.249
VO 15
IS 4
A1 F A Riordan
A1 A P Thomson
A1 J A Sills
A1 C A Hart
YR 1998
UL http://emj.bmj.com/content/15/4/249.abstract
AB 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.