Sepsis

Question 1

Signs and symptoms of SIRS (systemic inflammatory response syndrome)?

Answer 1

Abnormal core temperature
Abnormal WCC
Abnormal HR
Raised RR

Question 2

Red flag symptoms suggestive of Sepsis?

Answer 2

• Hypotension
• Prolonged cap refill >5sec
• Oxygen needed to maintain sats 92%
• AVPU (V,P,U)
• Lactate 2+
• pale / non blanching rash

Question 3

Unspecific neonatal signs of sepsis?

Answer 3

Very dry nappies
lack of response social cues
significantly decreased activity
weak
high pitched continuous crying

Question 4

What causative organism causes early onset (first week of life) neonatal sepsis?

Answer 4

GBS
E-coli
L.monocytogenes

Question 5

What causative agents cause late onset neonatal sepsis?

Answer 5

Coagulase negative staphylococcus (CoNS)

Question 6

Paediatric sepsis 6 to be started within an hour

What is it?

Answer 6

Give high flow oxygen
Obtain IV access
Give IV antibiotics
Consider fluid resuscitation
Involve senior clinician
Consider inotropic support early

Question 7

IV fluid resuscitation volume for children with sepsis?

Answer 7

20mL/kg 0.9% NaCl bolus over 5-10 minutes

Question 8

Which bloods to take when managing sepsis?

Answer 8

Clotting profile (DIC risk)

Blood culture

CRP (takes 12-24 hrs to rise)

VBG (lactate and glucose)

FBC

U&E + creatinine

Question 9

How to manage meningococcal sepsis?

Answer 9

Primary care: IM benzylpenicillin

hospital : IV cefotaxime (or ceftriaxone depending on age)

Question 10

How to manage early onset sepsis?

Answer 10

For GBS, L.monocytogenes, E-coli:

IV cefotaxine + amikacin + ampicillin

Question 11

How to manage late onset sepsis?

Answer 11

For CoNS (s.epidermidis)

IV meropenem + amikacin + ampicillin