Abstract
The Therapeutic protocol of invasive meningococcal disease (IMD) is intended for hospital treatment at departments of infectious diseases, pediatrie departments, intensive care units and eritical care units of departments of anaesthesiology, resuscitation and intensive care. Therapy of severe forms of IMD should be carried out in speciál centers with complete diagnostic and therapeutic servis available.
Timely initiati-on of therapy is a basic condition for a favorable outcome. Delayed therapy till the moment of admission in a speciál center is a big mistake.
This protocol was developed in extention of the IMD therapeutic protocol for urgent prehospital care published in 2002. In the introduction of the therapeutic protocol there are described characteristics of the clinical picture and IMD is classified according to its clinical forms.
The initial resuscitation of adult and paediatric patients fol-lows. Diagnostic procedures protocol is realized in parallel with initial resuscitation.
During assessment of the patienťs generál condition it is necessary to evaluate signs typical for severe forms of IMD. Their presence is an indication for admission of the patient to the intensive or eritical care unit.
Antibiotic therapy introduced within 30 minutes from the first suspicion of IMD represents the basic priority. A review of hemodynamic parameters under monitoring follows with their target values.
In addition to volume therapy, possibilities of catecholamin circulatory support, indications for ventilátory support, corticosteroid therapy, possibilities of therapy of emocoagulation disorders, therapy of intraeranial hypertension and additional therapeutic procedures are includ