Right Decisions
NHS Tayside ED Guidance
Paediatrics
Meningitis and sepsis
Management of bacterial meningitis
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Management of bacterial meningitis in infants under 3 months Q & A algorithm
Monitor, review and pathogen identification

Update your RDS mobile app to v4.7.2 to download toolkits even when website is down.

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. You will see that each toolkit has a small QR code icon in the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively update to the latest release - RDS app version 4.7.1 - to see this improvement.

Updating to this latest version of the RDS app is also strongly recommended to get the full benefits of the new resilience arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

Monitor, review and pathogen identification

NHS Tayside ED Guidance

100% maintenance fluids: enteral feeds if tolerated or isotonic IV fluids e.g. 0.9% Sodium Chloride with 5% Glucose
Do not restrict fluids unless there is evidence of increased ADH secretion (SIADH) or raised intracranial pressure (RICP)
Monitor fluid administration, urine output, electrolytes and blood glucose
Consideration of imaging
Perform LP when contraindication no longer present
- LP: CSF – MC&S, glucose, protein, viral PCR (herpes, enterovirus, parechovirus) and bacterial PCR.
- LP information leaflet available for parents
- Contraindications to LP:
  - Shock
  - Coma
  - Less than 30 minutes after convulsion
  - Coagulation abnormalities
    - clotting study results (if obtained) outside normal range
    - platelet count below 100 x 109/L
    - on Anticoagulant therapy
    - local superficial infection at LP site
    - respiratory insufficiency
    - other clinical or radiological signs of raised intracranial pressure (RICP): reduced (GCS ≤8) or fluctuating level of consciousness, relative bradycardia and hypertension, focal neurological signs, abnormal posture or posturing, unequal, dilated or poorly responsive pupils, papilloedema (late sign), abnormal ‘doll’s eye’ movements.
Liaise with neurosurgical/PID unit if complications

Has a specific pathogen been identified?

Yes

No

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