Fast meningococcal diagnosis saves little Arthur's life

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In January this year, North Lakes Station paramedics Kasey Furnell, Jayson Schmidt, Rebecca Atwell and Craig Tarrant were called to a three-year-old child who was becoming increasingly unwell.

When North Lakes parents Shannon and Garth James noticed their toddler Arthur, was suffering from extremely high temperatures, fatigue, vomiting and body aches, they called Triple Zero (000) and spoke with Emergency Medical Dispatcher (EMD) Sarah Davies-Richards.

Sarah quickly identified Arthur’s symptoms were potentially life-threatening.

Within minutes, Advanced Care Paramedics (ACPII) Rebecca and Craig arrived on scene and quickly identified Arthur would need the extra medications Critical Care Paramedics (CCP) carry and radioed for back up.

CCPs Jayson and Kasey, arrived on the scene shortly after.

Jayson said when they arrived on scene, Arthur seemed well, however his symptoms had not subsided after Shannon and Garth gave him paracetamol.

"I arrived on scene to meet the ACPII crew who had identified the petechial rash that was suspicious for potential meningococcal disease,” Jayson said.

“The patient also had a high fever which remained high for around 60-90 minutes post paracetamol administration which was given prior to QAS arrival.

“Given the high fever plus the petechiae we decided to treat Arthur for meningitis,” he said.

ACPII Rebecca cannulated an understandably scared and uncomfortable Arthur, who was then medicated with one gram of intravenous (IV) antibiotic ceftriaxone, and rushed to Redcliffe Hospital for further treatment.

Well after Arthur arrived at hospital he developed the more classic symptoms of a bacterial infection, such as headache, neck pain and had a toxic/septic looking appearance.

It was at this time the hospital performed a lumbar puncture which confirmed his meningococcal meningitis as the diagnosis.

Redcliffe Hospital staff praised the paramedics for their early identification and treatment, which they say helped Arthur's recovery, ultimately saving his life.

Jayson expressed how important early identification was to Arthur’s outcome and in turn commended Rebecca and Craig for flagging his symptoms.

“It is so important to administer early antibiotics once meningococcal disease is suspected as delayed antibiotics  can increased morbidity and mortality,” Jayson said.

In March, Arthur’s parents Shannon and Garth contacted the QAS to thank the four paramedics and EMD, as Arthur had recovered tremendously, without any deficits.

A reunite was organised at Parliament House with Shannon, Garth, Arthur and his big sister Clara so they could meet their ‘health heroes’, along with the Health and Ambulance Services Minister Shannon Fentiman, who presented Arthur and Clara with their own cuddly little QAS teddies.

Jayson said it was fantastic to meet with the family in much more relaxed and happier circumstances and to see the little “Spider Man” loving toddler doing so well.
“We were all very pleased to see Arthur in great health,” Jayson said.

“It could easily have been a very different story if Shannon and Garth had not called QAS when they did.”

Jayson said in his nine years of being on road as a paramedic, Arthur’s case was his first call-out to a child with meningococcal disease, which, he said is why keeping up to date with the Clinical Practice Guidelines (CPG) is crucial for paramedics.

“I review QAS protocols and the CPG often to stay up to date with general CPG knowledge, especially on rarely encountered conditions,” he said.

“The protocol for meningococcal disease is straightforward, if a paramedic suspects meningococcal disease as a differential diagnosis and there is evidence of a rash, ceftriaxone should be considered.”

On 1 March 2024, Queensland’s Health and Ambulance Services Minister Shannon Fentiman announced the rollout of a free meningococcal B (MenB) vaccination to nearly half a million children and adolescents.

The state-funded MenB program will be delivered through registered vaccination service providers including general practitioners, community vaccination clinics, pharmacies, and Aboriginal and Torres Strait Islander Health Services.

More information on meningococcal disease and the Queensland Meningococcal B Vaccination Program is available on the Vaccination and Immunisation Matters website.