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Septicaemia (children) - Draft

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Overview

Septicaemia (Sepsis) is a life threatening condition (1).

If suspected in the community then 999 should be called to arrange immediate transfer to hospital.

Sepsis can be difficult to spot but should be considered in all patients with symptoms or signs of an infection.

Risk factors for sepsis include extremes of age; people who are frail, immunocompromised or immunosuppressed; people who have had recent trauma or surgery; people with a breach in skin integrity; and women who are pregnant, are post-partum, or have had a recent termination of pregnancy or miscarriage.

The following page is a guide to suspected sepsis in children (aged 0-15 years).

See also the Remedy page below for advice on assessment of childrem in primary care:

Assessment of acutely unwell children

For suspected sepsis in adults (aged >16 years old) please see:

Septicaemia (adults) - Draft

Sepsis in Children

When to suspect sepsis in a child

A child may have sepsis if they (2):

Are breathing very fast
Have a ‘fit’ or convulsion
Look mottled, bluish, or pale – on darker pigmented skin, colour changes may show on the inside of the forearms or palms
Have a rash that does not fade when you press it
Are very lethargic or difficult to wake
Feel abnormally cold to touch

A child under 5 may have sepsis if they (2):

Are not feeding
Are vomiting repeatedly
Have not passed urine for 12 hours

Assessment Tools

The UK Sepsis Trust has tools for use in children (3):

If sepsis is suspected in the community then 999 should be called to arrange immediate transfer to hospital.

Pre- hospital antibiotics for children (aged 0-15 years) with suspected sepsis

Pre-hospital antibiotics for children with suspected sepsis, while sometimes considered, are not routinely recommended.

At present there is no local or national guidance on the use of pre-hospital antibiotics in children other than for those with suspected meningitis/ meningococcal disease (see below).

Meningitis or Meningococcal disease

See Meningitis - bacterial meningitis and meningococcal disease - Management | CKS | NICE (5) -includes advice on doses of antibiotics for children and adults.

This gives the following advice:

Do not delay transfer to hospital to give antibiotics to people with suspected or strongly suspected bacterial meningitis or meningococcal disease.
Give intravenous or intramuscular ceftriaxone or benzylpenicillin to people with strongly suspected:
- Bacterial meningitis if there is likely to be a clinically significant delay in transfer to hospital.
- Meningococcal disease as soon as possible, unless this will delay transfer to hospital.

See the CKS link (5) for recommended antibiotic and doses.
Do not give antibiotics if the person has severe antibiotic allergy to either ceftriaxone or benzylpenicillin.

Resources

(1) Symptoms of sepsis - NHS (www.nhs.uk)

(2) About Sepsis | Sepsis Symptoms | The UK Sepsis Trust

(3) Clinical tools - The UK Sepsis Trust

(4) Sepsis | Health topics A to Z | CKS | NICE

(5) Meningitis - bacterial meningitis and meningococcal disease | Health topics A to Z | CKS | NICE

Efforts are made to ensure the accuracy and agreement of these guidelines, including any content uploaded, referred to or linked to from the system. However, BNSSG ICB cannot guarantee this. This guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer, in accordance with the mental capacity act, and informed by the summary of product characteristics of any drugs they are considering. Practitioners are required to perform their duties in accordance with the law and their regulators and nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.

Information provided through Remedy is continually updated so please be aware any printed copies may quickly become out of date.