10 - Paediatric Sepsis Flashcards

1
Q

What is the definition of paediatric sepsis?

A

SIRS + Suspected/Proven Infection

Severe when CVS or Respiratory Shock

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2
Q

What is the q-SOFA score?

A

ICU mortality prediction score, to help identify patients with suspected infection that are at high risk for poor outcome outside of the ICU.

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3
Q

What components of arterial blood gases can help to predict the severity of childhood sepsis?

A

Acid/Base Balance and Lactate

Lactate is raised when decreased organ perfusion so anaerobic respiration! Sign of septic shock

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4
Q

What is the difference between hypovolemic and septic shock?

A

Hypovolemic is low blood circulating volume whereas septic is a distributive shock due to vasodilation so wouldn’t want to give fluids as could overload, would give vasoconstrictors

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5
Q

What are the 5 time specific goals that need to be completed within an hour when you suspect sepsis in a child?

A

Give oxygen at same time as getting IV or IO access

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6
Q

What are some signs of sepsis in children?

A
  • Normal temperature or raised temperature coming down does not reassure
  • Looks unwell
  • Parental concern
  • Raised EWS
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7
Q

What should the action plan be once a child presents with an infection?

A
  • If high risk give antibiotics in less than an hour and if raised lactate give fluid bolus
  • If moderate risk review bloods and decide in 3 hours whether to give antibiotics
  • If low risk manage patient
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8
Q

What are some risk factors that mean a child is at high risk of developing sepsis?

A
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9
Q

What is the ABCDE approach or childhood sepsis?

A
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10
Q

Why is sepsis hard to diagnose?

A

Many of the symptoms of sepsis, such as fever and difficulty breathing, are the same as in other conditions and there is no specific test for sepsis

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11
Q

What is the SEPSIS 6 steps that need to be carried out in a paediatric context?

A
  1. Give high flow oxygen
  2. Obtain IV/IO access and take blood tests
  3. Give antibiotics
  4. Consider fluid resuscitation (lactate)
  5. Involve senior clinicians early
  6. Consider ionotropic support early
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12
Q

What antibiotics are given to children with suspected sepsis?

A

SEPSIS BOX

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13
Q

What are the common causative organisms of childhood sepsis?

A
  • E Coli
  • Strep Pneumoniae
  • Neisseria Meningitidis
  • Staph Aureus
  • HiB
  • Bordetella Pertussis
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14
Q

What are some of the severe consequences of sepsis in childhood?

A
  • Cognitive Dysfunction
  • Physical Disability
  • Psychological effects (difficulty sleeping and hallucinations)
  • Death
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15
Q

What is post sepsis syndrome?

A

Can occur for months or years after sepsis:

  • feeling very tired and weak, and difficulty sleeping
  • lack of appetite
  • getting ill more often
  • changes in your mood, or anxiety or depression
  • nightmares or flashbacks
  • post-traumatic stress disorder (PTSD)
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