“What should we watch for, Doctor?”
It's a question GPs like me get all the time from parents at the end of a consultation. Wouldn’t it be amazing if we were 100% sure we knew what’s wrong with that feverish 4 year old patient sitting in their parent’s lap? For many reasons this is difficult, and we simply don’t always know exactly what is wrong.
Some illnesses start slowly with just vague symptoms, and nothing that sets it apart from other similar illnesses. In fact, many children with very serious infections, like meningitis or sepsis, don’t have obvious signs of these illnesses when they are first taken to a doctor. It’s not that the parent hasn’t explained their child’s illness clearly enough, or that the doctor is rushed or not doing a good job (though these can occur sometimes), it's that meningitis or sepsis may not be obvious when it first starts.
It’s not unique to meningitis. Other serious illnesses like cancer in adults can start with non-specific symptoms, and over time become more obvious and get diagnosed. Meningitis, however, changes from mild symptoms to a very serious infection over the space of a few hours, so the window of opportunity to be diagnosed and treated promptly is small.
This is why having a ‘safety net’ to ‘catch’ the child, whose illness changes from not too worrying one moment but then deteriorates the next, is so important for parents and GPs. Just as a physical safety net under a high wire trapeze artist can catch them if they fall, parents and doctors need a ‘safety net’ to prevent avoidable harm.
But what exactly IS a safety net when it comes to your child? Simply put, it is a way to empower parents. At the end of a consultation, there are four important questions parents should ask:
- What should I expect with the time course of this illness?
- What else could it be if you are not sure right now?
- Exactly what symptoms should we look out for that might mean it is something different or getting worse?
- How and when should we access a health care provider again?
Parents should leave any consultation (with a GP, Emergency Department, Walk In or NHS Direct) armed with the answers to these questions. This information might be given verbally, in information leaflets, or nowadays many parents can be directed to websites - such as Meningitis Research Foundation.
While this might seem simple, recent research by MRF has shown that parents often do not feel empowered with this information - or it may be overlooked in a busy consultation. For most children, parents won’t need to return for further health care as they have simple viral illnesses, and will get better on their own. But for those few children with meningitis or sepsis, whose illness worsens, a 'safety net' really can be the difference between life and death.