Nurses' Corner – Meningitis training with the Brian Injury Group

14 June 2019

Nick Copeland

In this month’s edition of Nurses corner I look at the meningitis training I recently attended, run by the Brain injury group at the Boyer Turner offices in Reading.

The aim of the training was to give an in-depth look at Meningitis for clinical negligence lawyers, barristers, insurers, case managers, health & social care professionals and charities who support those affected by Meningitis.

The training covered what Meningitis is, the breaches of duty, associated complications and rehabilitation needs, prosthetics and Quantum in Meningitis cases. 

Throughout my nursing career I had only ever seen a couple of cases of this diagnosis, so the training was a fantastic opportunity to refresh my knowledge regarding the specifics of the diagnosis and the disease.

The session opened with an overview given by two of Premex’s own experts – Dr. Nelly Ninis and Professor Simon Kroll. They provided an interesting overview of Meningitis as well as looking at its causation.

They described the signs and symptoms associated with Meningitis in young children, one of which was a high pitched cry/scream. This was one of the symptoms that I unfortunately remember vividly, when I was working in A&E and a child came in presenting with some of the symptoms associated with Meningitis.

The presentation also referenced the NICE guidelines for fever guidelines/sepsis, something we can all refer to looking at symptoms and the management of the patient throughout the illness. 

Reference was also made to Meningitis in new-borns and how this is associated with Group B streptococcus. This was particularly topical given a recent focus in the media with regards to maternal screening for the disease/condition. The US are already screening pregnant ladies at 35 weeks gestation and treating with prophylactic antibiotics if a positive diagnosis is made. In the UK if a mum presents with positive results from another clinic, for example following a private appointment, then the same treatment is then prescribed.

Dr Boyd, another Premex+ expert who was also presenting information of the Breach of Duty associated with Meningitis in general practice. He highlighted that there are approximately 3,000 diagnosed cases of Meningitis per year from a total of 42,000 GPs in practice. On average Dr Boyd said that each GP would have two paediatric cases and one adult in their career.

We all got a chance to play the role of a GP and decide if the treatment afforded in his sample case was appropriate based on the day’s learnings, and our clinical understanding of meningitis. It also gave a view of the level of detail and information required when dealing with paediatric cases. If this detail is not digested and recognised it can mean miss-diagnosis of patients and potentially fatal outcomes.

Following Dr Boyd’s Breach of Duty presentation, Professor Hanspal provided a detailed overview of the associated complications and rehabilitation needs of children following a meningitis diagnosis.

He looked at how there are no specific paediatric rehab centres in the UK and spoke about the need for ‘habilitation’ rather than ‘rehabilitation’ – as these children quite often grow up with a loss of limb and therefore know no difference. He explained about the damage caused to the growth plates following amputations and the consequences associated for the child in regards to limb lengthening surgery.

Dr Henderson Slater, another expert on the Premex+ panel, walked us through the associated complications and rehabilitation needs of adult patient’s post- diagnosis, and really stressed the importance of multi-disciplinary team work. Dependant on the severity and damage caused through contracting meningitis it may require different layers or rehabilitation and multiple expert types, which should be instructed to support the recovery of the patient and the subsequent medico-legal claim. 

As part of the rehabilitation process, experts work with their patients to understand and set, personal goals to aid in their recovery. So if a patient was a keen fisher before contracting meningitis for example, then their goal may to get back to fishing at the end of their rehabilitation and the expert should help them work towards this.

Patient rehabilitation is not always so straight forward however. Sometimes recovery means having to use multiple specialisms and experts to ensure the greatest results are achieved.

The final expert on the Premex+ panel, Matthew Hughes from Dorset Orthopaedic, gave an insight into state of the art prosthetics available in the current market. He explained that not all clients want prosthetics, but if they do it’s usually to improve aesthetics or to aid in functionality. The array of options available to patients now is fantastic and offers something for most adults. Unfortunately there is still a relatively small choice for paediatric componentry due to the level of expense and weight of the materials used.

The session was then rounded up with Chris Bright, Head of Clinical Negligence Group at No5 Barristers, presenting a legal update on the quantum in meningitis cases. He covered what aspects of the patient’s case will affect the outcome and level of remuneration with supporting case law.

The overall session was a fascinating and a fantastic refresher of the meningitis disease, its diagnosis and the subsequent rehabilitation and perusal of damages following a medico-legal claim.

This was my first BIG course and certainly won’t be my last. Having been in clinical practice for over 10 years it is important that I regularly attend training and keep informed on the latest medical developments. If you are looking for informative courses, with presentations delivered by first class speakers then I would highly recommend booking onto one of these courses. To find out more about the BIG courses follow the link here.