MANAGEMENT OF SEPSIS IN CHILDREN- PAEDIATRIC SEPSIS 6
Paediatric Sepsis
Reviewed Nov 2014
Due for Review Nov 2017
Issue 1 Page 1 of 5
A. INTRODUCTION
The inflammatory triad of fever, tachycardia & abnormal perfusion is very common in Children with benign infections.
Definitions (adapted from the international paediatric sepsis consensus conference definitions): 1. Infection - Proven infection by positive culture, microscopy, or PCR test caused by any pathogen OR - Clinical syndrome associated with a high probability of infection, as evidenced from clinical examination,imaging, or laboratory tests
2. Sepsis - Infection + Systemic Inflammatory Response Syndrome (tachycardia, tachypnoea, core temperature >38.5°C or <36°C, white cell count elevated or depressed for age) 3. Severe sepsis – Sepsis plus one of the following: cardiovascular dysfunction OR acute respiratory distress syndrome OR - Two or more other organ dysfunctions (respiratory, renal, neurologic, hematologic, or hepatic). 4. Septic shock - Severe Sepsis with cardiovascular dysfunction
B. THE RECOGNITION AND CLINICAL DIAGNOSIS OF SEPTIC SHOCK
• Suspected infection • Hypo or hyperthermia (temp <36℃ or >38.5℃) • Tachycardia • Tachypnoea • Altered mental status • Decreased urine output (<1 ml/kg/min) • Other end organ dysfunction • Signs of either cold or warm shock
MANAGEMENT OF SEPSIS IN CHILDREN- PAEDIATRIC SEPSIS 6
Paediatric Sepsis
Reviewed Nov 2014
Due for Review Nov 2017
Issue 1 Page 2 of 5
C. THE FIRST HOUR OF RESUSCITATION
Goals to restore:
Normal mental status Normal range heart rate for age Normal range respiratory rate for age (may not be possible if the underlying cause is pneumonia) Capillary Refill Time <3s Palpable peripheral pulses Normal range blood pressure for age. Adequate urine output Serum lactate < 2
MANAGEMENT OF SEPSIS IN CHILDREN- PAEDIATRIC SEPSIS 6
Paediatric Sepsis
Reviewed Nov 2014
Due for Review Nov 2017
Issue 1 Page 3 of 5
MANAGEMENT OF SEPSIS IN CHILDREN- PAEDIATRIC SEPSIS 6
Paediatric Sepsis
Reviewed Nov 2014
Due for Review Nov 2017
Issue 1 Page 4 of 5
MANAGEMENT OF SEPSIS IN CHILDREN- PAEDIATRIC SEPSIS 6
Paediatric Sepsis
Reviewed Nov 2014
Due for Review Nov 2017
Issue 1 Page 5 of 5
D. REFERENCES
• http://www.survivingsepsis.org/Guidelines/Documents/Pediatric%20table.pdf (The Paediatric Sepsis 6 Initiative)
• Dellinger RP, Levy MM, Rhodes A, et al: Surviving Sepsis Campaign: International guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med.
2013; 41:580-637
• Daniels R, Nutbeam T, McNamara G, Galvin C. The Sepsis Six and the Severe Sepsis resuscitation Bundle – a prospective observational study. Emergency Medicine Journal 2011; 28(6): 507-512
• J Tong et al Arch Dis Child 2014;99: G218(P) The Paediatric Sepsis 6 Initiative
E. AUTHORS:
Dr Ashok Aralihond, Paediatric Consultant
Reviewed November 2014
Next Review November 2017