Patients admitted to hospital
Before discharging a child or young person who has been diagnosed with bacterial meningitis and treated in hospital:[2]National Institute for Health and Care Excellence. Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management. Feb 2015 [internet publication].
https://www.nice.org.uk/guidance/cg102
Consider their follow-up requirements, taking into account potential sensory, neurological, psychosocial, orthopaedic, cutaneous, and renal morbidities
Discuss potential long-term effects and likely patterns of recovery with the child or young person and their parents or carers; provide opportunities to discuss issues and ask questions.
Offer children and young people and their parents or carers:[2]National Institute for Health and Care Excellence. Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management. Feb 2015 [internet publication].
https://www.nice.org.uk/guidance/cg102
Offer a formal audiological assessment as soon as possible, within 4 weeks of being fit to test, and preferably before discharge from hospital.[2]National Institute for Health and Care Excellence. Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management. Feb 2015 [internet publication].
https://www.nice.org.uk/guidance/cg102
If the child or young person has severe or profound deafness, offer an urgent assessment for cochlear implants as soon as they are fit to undergo testing.[2]National Institute for Health and Care Excellence. Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management. Feb 2015 [internet publication].
https://www.nice.org.uk/guidance/cg102
See Assessment of hearing loss.
Ensure children and young people are reviewed by a paediatrician (with the results of their hearing test) 4-6 weeks after hospital discharge to discuss morbidities associated with their condition and be offered referral to appropriate services.[2]National Institute for Health and Care Excellence. Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management. Feb 2015 [internet publication].
https://www.nice.org.uk/guidance/cg102
Inform the child’s or young person’s general practioner, health visitor, and school nurse (if at school) about their bacterial meningitis.[2]National Institute for Health and Care Excellence. Meningitis (bacterial) and meningococcal septicaemia in under 16s: recognition, diagnosis and management. Feb 2015 [internet publication].
https://www.nice.org.uk/guidance/cg102
Patients seen in hospital or the community and not admitted to hospital
If your initial assessment rules out any suspicion of bacterial meningitis and you decide the patient can be managed in the community, ensure you give thorough safety netting advice.[53]Meningitis Research Foundation. Meningococcal meningitis and sepsis guidance notes: diagnosis and treatment in general practice. 2018 [internet publication].
https://www.meningitis.org/getmedia/cf777153-9427-4464-89e2-fb58199174b6/gp_booklet-UK-sept-16
Encourage the parent/patient to trust their instincts and seek medical help again if the illness gets worse, even if this is shortly after the patient was seen.[53]Meningitis Research Foundation. Meningococcal meningitis and sepsis guidance notes: diagnosis and treatment in general practice. 2018 [internet publication].
https://www.meningitis.org/getmedia/cf777153-9427-4464-89e2-fb58199174b6/gp_booklet-UK-sept-16
Give advice on accessing further health care and ensure the parent/patient understands how to get medical help after normal working hours.[53]Meningitis Research Foundation. Meningococcal meningitis and sepsis guidance notes: diagnosis and treatment in general practice. 2018 [internet publication].
https://www.meningitis.org/getmedia/cf777153-9427-4464-89e2-fb58199174b6/gp_booklet-UK-sept-16
Provide information on symptoms of serious illness, including how to identify a non-blanching rash and the tumbler test.[53]Meningitis Research Foundation. Meningococcal meningitis and sepsis guidance notes: diagnosis and treatment in general practice. 2018 [internet publication].
https://www.meningitis.org/getmedia/cf777153-9427-4464-89e2-fb58199174b6/gp_booklet-UK-sept-16
Suggest follow-up within a specified period if you consider this to be appropriate.[53]Meningitis Research Foundation. Meningococcal meningitis and sepsis guidance notes: diagnosis and treatment in general practice. 2018 [internet publication].
https://www.meningitis.org/getmedia/cf777153-9427-4464-89e2-fb58199174b6/gp_booklet-UK-sept-16
Use your clinical judgement.