Monitoring
In hospital
Measure and record the following at least every hour, in line with local protocols and/or your institution’s recommended early warning or risk stratification system:[31][48]
Heart rate
Respiratory rate and extent of respiratory distress
Oxygen saturations
Blood pressure
Temperature
Perfusion (capillary refill)
Neurological assessment (such as the Alert, Voice, Pain, Unresponsive [AVPU] scale)
Be aware that children and young people with bacterial meningitis (particularly meningococcal meningitis) can deteriorate rapidly regardless of the results of any initial assessment of severity. See Meningococcal disease.
Long-term
Offer a formal audiological assessment as soon as possible, within 4 weeks of being fit to test, and preferably before discharge from hospital.[2]
If the child or young person has severe or profound deafness, offer an urgent assessment for cochlear implants as soon as they are fit to undergo testing.[2] See Assessment of hearing loss.
Ensure children and young people are reviewed by a paediatrician (with the results of their hearing test) 4-6 weeks after hospital discharge to discuss morbidities associated with their condition and be offered referral to appropriate services.[2]
Although formal testing for cognitive, academic, and behaviour problems is not generally necessary, it is important to monitor the child's progress over time. All patients should be reviewed once a year to detect any long-term complications.
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