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Meningococcal sepsis — DipIMC MCQ

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ModerateMedical EmergenciesMeningococcal sepsisDipIMC

A 17-year-old has fever, confusion, leg pain and a non-blanching purpuric rash at home. He is hypotensive and the nearest hospital is 18 minutes away. What is the most appropriate drug/dose?

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Correct answer: DGive parenteral benzylpenicillin according to local protocol and transfer urgently

Give parenteral benzylpenicillin according to local protocol and transfer urgently is the best answer because suspected meningococcal septicaemia warrants immediate parenteral antibiotic treatment when available. Give intravenous adrenaline 1 mg as a rapid bolus is less appropriate because IV bolus adrenaline is reserved for cardiac arrest or expert titrated use; Give intramuscular adrenaline 1 mg is less appropriate because 1 mg intramuscular adrenaline is not the standard anaphylaxis dose. Delay medication until hospital review and Give nebulised salbutamol as sole treatment are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; NICE Meningitis guidance