10 - Paediatric Sepsis Flashcards
What is the definition of paediatric sepsis?
SIRS + Suspected/Proven Infection
Severe when CVS or Respiratory Shock
What is the q-SOFA score?
ICU mortality prediction score, to help identify patients with suspected infection that are at high risk for poor outcome outside of the ICU.
What components of arterial blood gases can help to predict the severity of childhood sepsis?
Acid/Base Balance and Lactate
Lactate is raised when decreased organ perfusion so anaerobic respiration! Sign of septic shock
What is the difference between hypovolemic and septic shock?
Hypovolemic is low blood circulating volume whereas septic is a distributive shock due to vasodilation so wouldn’t want to give fluids as could overload, would give vasoconstrictors
What are the 5 time specific goals that need to be completed within an hour when you suspect sepsis in a child?
Give oxygen at same time as getting IV or IO access
What are some signs of sepsis in children?
- Normal temperature or raised temperature coming down does not reassure
- Looks unwell
- Parental concern
- Raised EWS
What should the action plan be once a child presents with an infection?
- If high risk give antibiotics in less than an hour and if raised lactate give fluid bolus
- If moderate risk review bloods and decide in 3 hours whether to give antibiotics
- If low risk manage patient
What are some risk factors that mean a child is at high risk of developing sepsis?
What is the ABCDE approach or childhood sepsis?
Why is sepsis hard to diagnose?
Many of the symptoms of sepsis, such as fever and difficulty breathing, are the same as in other conditions and there is no specific test for sepsis
What is the SEPSIS 6 steps that need to be carried out in a paediatric context?
- Give high flow oxygen
- Obtain IV/IO access and take blood tests
- Give antibiotics
- Consider fluid resuscitation (lactate)
- Involve senior clinicians early
- Consider ionotropic support early
What antibiotics are given to children with suspected sepsis?
SEPSIS BOX
What are the common causative organisms of childhood sepsis?
- E Coli
- Strep Pneumoniae
- Neisseria Meningitidis
- Staph Aureus
- HiB
- Bordetella Pertussis
What are some of the severe consequences of sepsis in childhood?
- Cognitive Dysfunction
- Physical Disability
- Psychological effects (difficulty sleeping and hallucinations)
- Death
What is post sepsis syndrome?
Can occur for months or years after sepsis:
- feeling very tired and weak, and difficulty sleeping
- lack of appetite
- getting ill more often
- changes in your mood, or anxiety or depression
- nightmares or flashbacks
- post-traumatic stress disorder (PTSD)
