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Immediate priorities
Immediate priorities
Airway risk
GCS 8 or less
Recurrent seizures
Loss of protective reflexes
Severe agitation needing deep sedation
Breathing
SpO2 target 94 to 98 percent
End tidal CO2 monitoring if intubated
Circulation
Two large bore IV
Hypotension trigger for sepsis pathway
MAP target 65 mmHg or higher
Glucose
Point of care glucose
If hypogly.reqia then dextrose per protocol
Temperature
Hyperthermia control
Hypothermia evaluation
Exposure and safety
Toxic ingestion screening triggers
Restraint only if immediate danger
Time critical disease control
Time critical disease control
Empiric antiviral and antibacterial coverage
If encephalitis suspected then acyclovir without delay
If meningitis cannot be excluded then add empiric antibiotics
Seizure control
If convulsive seizure then benzodiazepine first line
If status epilepticus then second line antiseizure medication
Raised intracranial pressure risk
Head of bed 30 degrees
Neck midline
Avoid hypotension
Avoid hypoxia
Isolation
Droplet precautions until meningococcal excluded
Consultation and escalation
Consultation and escalation
Early ICU involvement
Declining mental status
Refractory seizures
Shock
Respiratory failure
Infectious diseases
All suspected encephalitis admissions
Immunocompromised hosts
Neurology
Seizures
Focal deficits
Suspected autoimmune encephalitis
Public health triggers
Suspected arboviral encephalitis
Cluster cases
Travel related exposure
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.