A little rash

Patient
script

You are Ms Valerie Andrews (DOB 17 November 1988) 23-years-old, who works
as a nursery nurse in a local nursery. You are normally very fit and well with no
medical problems.
You started to come down with what you thought was flu last night. You were
really looking forward to a night out at the pub with your colleagues (it was one of
the girls birthdays) but you had to excuse yourself and went home at about
1830 h. You had been suffering with a sore throat all afternoon but in the pub you
started to feel hot and shivery, aching all over and really, really rough. You felt
so poorly that you made yourself a hot toddy, drank it with two or three
paracetamol tablets and took yourself off to bed. You must have been asleep
about an hour or two when you woke shivering and sweating like crazy I was
drenched. It was then that you started to get a headache. At first it wasnt too
bad and you took some Nurofen and managed to doze a bit but by midnight or
so it started to get really bad. You took a few more paracetamol around 0100 h
but vomited them back up. By this point your partner, Angie, had come back from
work (she works as a solicitor in a local law firm and often gets home late when
her work demands it). She wanted to call out the doctor then but you convinced
her not to. By about 05300600 h you were really suffering, and this is when
Angie called the doctor. He came at about 0630 h and sent you immediately in by
ambulance, after first giving you an injection in the back of your hand. You think it
was a shot of an antibiotic.
The headache is all over your head (global), with no radiation. It started slowly
and got worse and worse over a few hours. It was poorly relieved with
paracetamol and Nurofen. You have had no tablets for several hours.
Later ...
Despite the painkillers you still have a pretty severe headache, and are not really
in the mood to talk very much. However you are happy to listen to the doctors
explanation.
You have seen people on ER and Holby City have the needle in the back but
dont really know much about it. No one has explained it to you on this admission.
If the doctor is reassuring and provides an adequate explanation of a lumbar
puncture, you should be agreeable to have the procedure. If they are

A little rash

Patient
script

unsympathetic, unable to address your concerns, or provide a poor explanation

you should refuse the procedure.
Ideas and concerns: you are frightened that the needle will cause damage to your
spine and that this will leave you paralysed.
Expectations: None really; you just want to get it over and done with if it needs
to be done at all!