sepsis and child mortality Flashcards
how common is infection in paediatrics
- common in children
- avg pre-school child will have 8-12 resp infections p/a
- likely to spend 3-5mths p/a w/ viral infection
- majority due to viruses
- majority self limiting and last 8-14 days
infections and admissions to hospital
39% of all acute paeds admissions
25% of GP OOH - 60% of these are 1-4y/o
UK child mortality (<5y/o)
- 27 per 1000 live births
- 4% or 1/ 234 children
problems with child mortality in UK
- mortality outcomes are considerably worse than comparable HICs
- UK ranks in bottom 3 countries in the EU15+ for mortality from common infectious in both sexes and across all age groups
- mortality from treatable infection in UK - almost 2x that of best performing European neighbours
failure to recognise serious illness at the 1st point of healthcare contact is an important avoidable factor in child death
how many deaths does infection account for
16.2% deaths 1-4y/o
8% deaths 5-9y/o
causes of child death
infectious disease ~½ of all deaths
- pneumonia, diarrhoea diseases, meningitis, malaria, measles
neonatal disorders
injuries and accidents
non-communicable diseases
how common is sepsis
severe sepsis is one of the leading causes of death in all children
>½ of all sepsis cases worldwide occurred in children
when is the peak incidence of sepsis
early childhood
- infants <1y: 1 in 200
- children 1-4: 1 in 2000
- children 5-15: 1 in 5000
fatality from sepsis
10%
how to improve survival in sepsis
early recognition and appropriate treatment
- UK: only 38% compliance w/ recommended treatment guidelines
what is sepsis
sepsis = systemic inflammatory response syndrome (SIRS) + suspected/proven infection
what is severe sepsis
severe sepsis = sepsis + organ dysfunction
what is septic shock
septic shock = sepsis = CVS dysfuntion
what is SIRS
≥ 2 of:
- temp >38 or <36
- WCC >15x 10^9/L or <5x 10^9/L
- tachycardia >2SD above normal for age
- tachypnoea >2SD above normal for age
paediatric normal values
- faster HR as baby, slows gradually w/ age
- faster RR as baby, slow gradually w/ age