Septicaemia

Question 1

What is septicaemia?

Answer 1

A syndrome that occurs when an infection causes a child to become systemically unwell

Result of a severe systemic inflammatory response

Life-threatening condition

Question 2

Clinical features of septicaemia

Answer 2

Deranged physical observations

ProlongedCRT

Fever/hypothermia

Deranged behaviour

Poor feeding

Inconsolable or high pitched crying

High pitched or weak cry

Reduced consciousness

Reduced body tone (floppy)

Skin colour changes (cyanosis, mottled pale or ashen)

Shock involves circulatory collapse and hypoperfusion of organs

Question 3

Immediate management of septicaemia

Answer 3

Call for senior help

O2if shockor sats<94%

IV access

Bloods inc. FBC,U&E,CRP,clotting screen(INR),blood gasforlactateandacidosis

Blood cultures, ideally before giving antibiotics

Urine dipstickand laboratory testing forculture and sensitivities

Antibiotics

IV fluids

Question 4

Investigations in septicaemia

Answer 4

CXR if pneumonia suspected

Abdominal and pelvic USSif intra-abdominal infection suspected

LP if meningitis is suspected

Meningococcal PCRblood test if meningococcal disease is suspected

Serum cortisolifadrenal crisisis suspected

Question 5

When is septic shock diagnosed?

Answer 5

When sepsis has lead to cardiovascular dysfunction

Question 6

Treatment of septic shock

Answer 6

Aggressive IV fluids

If fluids fail to work, transfer to ICU for inotropes