European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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In this review the epidemiology of bacterial meningitis and the new insights in the pathophysiology are thoroughly discussed. The different diagnostic steps are described and the present day antibiotic strategy and adjunctive inflammation-modulating therapy are delineated.
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For 25 years aggressive prehospital fluid administration in trauma patients has been common practice. Recent studies suggest that this may increase mortality in patients with hypovolaemic shock. ⋯ Fluid resuscitation before definitive haemostasis has been achieved, may accelerate blood loss, cause hypothermia and result in a dilutional coagulopathy. Further studies are needed to establish optimum volume replacement in trauma patients with hypovolaemic shock.