Start Broad spectrum antibiotics and arrange a CT brain scan

You prescribe some cefotaxime and arrange a CT scan. Rory’s mother does not at first understand why it is necessary for him to have antibiotics intravenously as he does not have a temperature. She calls her boyfriend who is not aware of these developments.

You arrange for a CT scan which will happen in about one hour. Meanwhile you are asked to review two other patients in the ED. The first is a two year old girl with diarrhea and features of dehydration. You start some nasogastric rehydration and also plan to review her later. The second is a six week old with breathing difficulties and coryza. You arrange a chest radiograph and send some blood tests.

When you return to see Rory again he is more drowsy than before. His father has arrived and wants to take him home. You persuade Rory's parents that it is best for Rory if the scan is done to identify what is wrong with him.

Before he leaves to go to the CT scanner his antibiotics are given.