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The setting
It's early on a Friday evening, and you're working as registrar in A&E. A 6 year old girl is rushed in as an emergency, complaining of headache; she is febrile with convincing nuchal rigidity. Your colleague performs a lumbar puncture, then you attempt to achieve intravenous access, and by the time the anaesthetic cream has cooked the microbiologist rings from the lab. The CSF contains 50 polymorphs, two red cells and is “teeming with Gram positive diplococci”.
The question
Before you give an antibiotic though, you wonder about the steroids in meningitis debate. Should this girl get dexamethasone prior to antibiotics? Will it reduce her chance of hearing loss—or just increase her chance of continued infection? You reckon the five minutes it will take to draw up the antibiotic is enough time to try to find some information to help.
The problem
In the setting of acute paediatrics, information needs to be delivered to those who provide care as quickly as possible. It has been suggested that immediate information should be accessible within 15 seconds, further information within three minutes, and a digest of some detail in around 10 minutes.1 The only way this is possible is by utilising electronic information sources. Furthermore, the information …
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