sepsis_flashcards
Amber/Red features – sick child and unknown source of infection
ABCDE approach, senior review and admit; Examination (resp, cardio, abdo, neuro) and obs; Initiate sepsis 6; Urine dip and MCS; LP; May need CXR; Chest monitoring and O2 sats; Explain to family
Green features – taking most feeds, saturating above 95%, normal colour, alert, playing, good cry, breathing normally
Explain – ‘So given what you’ve said, I think your child has a mild infection. The investigations done so far show that they are coping well with the infection and are not too unwell. I am happy to send you home with some antibiotics to give them. It is important that you maintain their fluid intake, give them lots of rest and check up on them during the night to make sure they don’t start struggling to breath or spike a temperature. If they suddenly get worse, fever worsens, breathing worsens, become dehydrated, stop eating or drinking, develop a non-blanching rash or they are still feverish in 4 days, you must come back to A&E. I will give you a leaflet with everything I have said and what you need to look out for that may mean you need to come back.’
Definition of sepsis
Life-threatening organ dysfunction due to dysregulated host response to infection.
Fever in <3 months
SEPSIS SEPSIS SEPSIS; May not always have fever -> non-specific symptoms
Risk factors for sepsis
Foetal factors: prematurity, infection in another baby in multiple pregnancy; Maternal factors: Invasive GBS infection during previous pregnancy, Maternal GBS in patient’s pregnancy, Pre-labour rupture of membranes, Preterm birth following spontaneous labour (<37 weeks), PROM (>18 hrs), Intrapartum fever >38 or suspected chorioamnionitis, Antibiotics during labour
Traffic light system for assessing risk of sepsis
High risk: No response to social cues, Appears ill to HCP, Does not wake, if roused does not stay awake, Weak high pitched or continuous cry; Grunting, Apnoea, O2 sats <90% in air; HR <60, Cap refill >3 seconds, Reduced urine output; Mottled or ashen appearance, Cyanosis of skin, lips or tongue, Non-blanching rash of skin; <36; Leg pain, Cold hands or feet
Management of sepsis
999; Call for help – give benzylpenicillin if meningitis (IV ceftriaxone in hospital); ABC approach; Fluid resuscitation; Bloods; Administer empirical antibiotics WITHIN 1 HR; Find source of infection; Monitor
