Home of Medicine with Dr Amie Burbridge and Dr Ben Lovell Headache and fever
Feb 23, 2024
This discussion highlights the intricacies of diagnosing headaches and fever, focusing on the risk of meningitis and the vital role of lumbar punctures. The hosts share insights on navigating decision fatigue in healthcare, emphasizing the need for self-care and reflection. They also address cognitive biases in clinical decision-making and the importance of learning from past mistakes. Personal experiences reveal the emotional challenges of managing patient overload, reminding everyone that it's okay to not always be okay.
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Meningitis Treatment
- Treat patients with suspected meningitis promptly with IV antibiotics and perform an LP.
- Don't delay LPs due to logistical issues or perceived risks.
Early LP in Meningitis
- Low CSF white cell count can occur in early meningitis, especially if antibiotics are given soon after symptom onset.
- Consider repeating the LP if initial results are negative but suspicion remains high.
Recency Bias Example
- Ben Lovell shares an example of a registrar who insisted on breast exams due to a past missed diagnosis.
- This highlights how recent case bias can lead to over-investigation.
