LOW RATES OF ADMINISTRATION OF PNEUMOCOCCAL VACCINATION IN OPEN HEAD TRAUMA DESPITE NATIONAL GUIDANCE
- Leanne Dearman, United Kingdom
- Leanne Dearman, United Kingdom
- Chris Kingsnorth, United States of America
- Salma Ali, United States of America
- Patrick Davies,
Abstract
Background
Invasive pneumococcal disease is a major cause of morbidity and mortality and is significantly more common in patients with open head trauma than the general population. Public Health England recommends that all such patients receive pneumococcal vaccination.
Objectives
Our aim was to assess whether patients presenting with open head trauma were immunised during their admission.
Methods
Analysis of digital health records, hospital reporting systems, and pharmacy dispensing for patients admitted to PICU between 01/01/2012–01/06/2018 identified 94 patients with major head trauma. 46 were excluded as their skull fracture was closed or notes were unavailable.
Results
48 patients had open head trauma. 15 (31%) received pneumococcal immunisation during their admission. 33 (69%) did not. 1 child presented 18 months post injury with devastating pneumococcal meningitis (albeit a strain not covered by the vaccination). Another received a prolonged course of antibiotics during her initial presentation for assumed meningitis (although all cultures were negative). Neither of these were immunised.
Conclusion
Our administration record was well below expected standards. We have contacted patients who did not receive pneumococcal vaccination and are arranging community administration. We are adding safeguards to ensure eligible patients are immunised at initial presentation. We plan to re-audit our performance 2 years after making these changes.