Childhood Sepsis

Question 1

Define sepsis

Answer 1

Infection leading to dysregulated host response and life threatening organ dysfunction

Question 2

Define childhood sepsis

Answer 2

At lest two of:
Temperature high or low
Heart rate high 
Breathing rate high
WCC high or low.
=SIRS
\+
Suspected / proven infection 
=sepsis 

Leads to shock! - Organ dysfunction (CVS or Respiratory or 2 or more other organs)

Question 3

What are the risk factors for childhood sepsis (where there is a lower threshold of suspicion)?

Answer 3

Age < 1 year
Impaired immunity
Recent trauma / surgery / skin breach

Question 4

What is the paediatric sespsis 6?

Answer 4

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

Question 5

What blood gas results could indicate the severity of sepsis?

Answer 5

Anion gap - shows presence of lactate

Question 6

How does sepsis presenting children?

Answer 6

.

Question 7

How does sepsis presenting children?

Answer 7

SIRS and organ dysfunction.

Question 8

What are common causative organisms of sepsis in children?

Answer 8

Neonatal - Group B strep (from mother), premature or membrane breaks

Babies - Respiratory syncytial virus (RSV)
Cytomegalovirus (CMV)
E. Coli
Candida
Herpes simplex virus
Listeria monocytogenes

Older children - any untreated illnesses, infected wounds

Question 9

What things need to be done within an hour?

Answer 9

1. Early recognition of severe sepsis
2. Vascular access
3. antibiotic administration
4. Administering IV fluids
5. Vasopressors or fluid refractory shock