Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
First-hour bundle
Airway and ventilation risk
GCS 8 or declining
Refractory hypoxemia
Persistent seizures
Hemodynamic instability
MAP < 65 mmHg
Lactate rising despite fluids
Early antimicrobials
Antibiotics within 1 hour when suspected bacterial meningitis
Do not delay antibiotics for CT head or lumbar puncture
Early diagnostics
Blood cultures before antibiotics when feasible without delay
Point-of-care glucose
Infection control
Droplet precautions for suspected meningococcal disease
Precautions until 24 hours after effective antibiotics for meningococcal disease
Neuroprotection and herniation risk
Raised intracranial pressure concern
Rapidly worsening mental status
Escalate to resuscitation bay
Immediate CT head before LP
Focal neurologic deficit
CT head before LP
Papilledema
CT head before LP
New onset seizure
CT head before LP
Immunocompromised state
CT head before LP
Pending LP with high ICP concern
Avoid LP if signs of impending herniation
Critical care and neurology consultation
Sepsis pathway integration
Septic shock pathway
Crystalloid bolus
30 mL/kg within 3 hours for hypotension or lactate 4 mmol/L
Vasopressor strategy
Norepinephrine first-line for persistent hypotension after fluids
Source control
Early antibiotics with CNS penetration
Identify parameningeal source
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.