Patient discussions

Children and young people aged under 16

Before discharging a child or young person who has been diagnosed with meningococcal disease and treated in hospital:[9]

  • 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:[9]

Offer a formal audiological assessment as soon as possible, within 4 weeks of being fit to test, and preferably before discharge from hospital.[9]

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.[9]

Ensure children and young people are reviewed by a paediatrician (with the results of their hearing test) 4 to 6 weeks after hospital discharge to discuss morbidities associated with their condition and be offered referral to appropriate services.[9]

Inform the child’s or young person’s GP, health visitor, and school nurse (if at school) about their bacterial meningitis or meningococcal sepsis.[9]

Refer children and young people with recurrent episodes of meningococcal disease for assessment by a specialist in infectious diseases or immunology.[9]

Refer children and young people with complement deficiency to a health professional with expertise in managing the condition.[9]

Adults

Provide assessment and arrange follow-up according to regional guidelines on rehabilitation after critical illness for any patient treated in a critical care setting at any point during their illness.[48] For example, the UK National Institute for Health and Care Excellence (NICE) guidelines on rehabilitation after critical illness.[95]

Arrange a hearing test for any patient who has had meningococcal disease (including meningococcal sepsis) if a clinician, the patient, or their family thinks hearing may have been affected.[48]

  • The hearing test should be carried out by a hospital based specialist and should take place before discharge or within 4 weeks of being well enough to test, whichever is sooner.

  • Patients found to have severe to profound deafness should be offered a ‘fast-track’ assessment for cochlear implant.

Arrange for patients who have had confirmed or probable bacterial meningitis to be given a medical follow-up appointment within 6 weeks after discharge.

Agree a rehabilitation plan with any patient with rehabilitation needs, and their family/carers.

Provide patients and their families with the contact details of support organisations.  Meningitis Research Foundation Opens in new window Meningitis Now Opens in new window

Patients seen in hospital or the community and not admitted to hospital

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.

  • Give advice on accessing further healthcare.

  • Provide information on symptoms of serious illness, including how to identify a non-blanching rash and the Tumbler test.[84]

Advise parents or carers of children and young people to go/return to hospital if the child or young person appears ill to them.[9]

Suggest follow-up within a specified period (usually 4-6 hours) if you consider this to be appropriate.[84] Use your clinical judgement.

  • Ensure the parent/patient understands how to get medical help after normal working hours.

  • Liaise directly with other healthcare professionals if you have concerns about a patient who is not being sent to hospital.

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