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Sepsis In Children

WHAT YOU NEED TO KNOW:

Sepsis happens when an infection spreads and causes your child's body to react strongly to germs. Your child's defense system normally releases chemicals to fight off infection at the infected area. When infection spreads, chemicals are released throughout your child's body. The chemicals cause inflammation and clotting in small blood vessels. The clots are often hard to control. Inflammation and clotting decrease blood flow and oxygen to your child's organs. This may cause your child's organs to stop working correctly. Sepsis is a life-threatening emergency.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Emotional support:

Stay with your child for comfort and support as often as possible while he is in the hospital. Ask another family member or someone close to the family to stay with your child when you cannot be there. Bring items from home that will comfort your child, such as a favorite blanket or toy.

Monitoring:

Healthcare providers will closely monitor your child's blood pressure, heart rate, breathing rate, and temperature. They will also ask you or your child about his or her pain. Your child may need any of the following:

  • A heart monitor records the electrical activity of your child's heart.
  • A pulse oximeter is a device that measures the amount of oxygen in your child's blood. A cord with a clip or sticky strip is placed on his or her finger, ear, or toe. The other end of the cord is hooked to a machine. An alarm will sound if your child's oxygen level is low or cannot be read. Never turn the pulse oximeter or alarm off.
  • A neurological exam is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show healthcare providers how well your child's brain is working during sepsis. Healthcare providers may check neuro signs every hour.
  • Intake and output may be measured. Healthcare providers will keep track of the amount of liquid your child is getting in the IV. They also need to know how much your child is urinating. Ask a healthcare provider if you need to save your child's wet diapers. They may keep track of his or her urine output by inserting a urinary catheter. A urinary catheter is a small, flexible tube that is inserted into your child's bladder to drain urine.
  • An arterial line is a tube placed into an artery, usually in your child's wrist or groin. The tube is attached to a monitor that keeps track of your child's blood pressure. An arterial line may also be used to take blood samples.
  • A central line is an IV catheter. It is put into a large blood vessel near your child's neck or groin, or near his or her collarbone. The central line may be used to give medicines or IV fluids, draw blood samples, or check your child's heart.

Tests:

  • Blood and urine tests may be done to check your child's blood cell levels, electrolyte levels, and blood sugar levels. These tests will also check for infection, and measure your child's liver and kidney function. A blood gas will show how much oxygen and carbon dioxide is in your child's blood. The results will tell healthcare providers how well your child's lungs, heart, and kidneys are working.
  • An x-ray, ultrasound, CT, or MRI may show where in your child's body the infection came from. Your child may be given contrast liquid to help the organs show up better in the pictures. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his or her body.
  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your child's heart. The test will also check for damage to your child's heart valves that may be caused by infection.
  • A lumbar puncture (spinal tap) may be done to test your child's cerebrospinal fluid (CSF) for germs. It can also check for signs of infection in or around his or her brain. CSF is the fluid that surrounds your child's spinal column and brain.

Medicines:

  • Blood pressure medicine increases your child's blood pressure. This medicine will also increase blood flow to his or her organs.
  • Heart medicine controls or lowers your child's heart rate.
  • Glucose increases your child's blood sugar level.
  • Insulin decreases your child's blood sugar level.
  • Acid-reducing medicine helps prevent stomach ulcers.
  • Blood thinner medicine helps prevent blood clots.
  • Antibiotics treat a bacterial infection. Your child may be given more than 1 type of antibiotic medicine.
  • Antifungals treat a fungal infection.
  • Sedatives help your child relax and feel calm. These may be given if your child is on a ventilator.
  • Pain medicine may be given. Do not wait until your child's pain is severe before you ask for more medicine.

Treatment:

  • Removal or change of a catheter or drain may be needed to get rid of the infection.
  • IV fluids may be given to treat or prevent dehydration. IV fluids also help increase blood flow to your child's organs, and increase his or her blood pressure.
  • Oxygen may be needed if your child's blood oxygen level is lower than it should be. Your child may get oxygen through a mask placed over his or her nose and mouth or through small tubes placed in the nostrils. Ask your child's healthcare provider before you take off the mask or oxygen tubing.
  • A ventilator is a machine that gives your child oxygen and breathes for him or her when he or she cannot breathe well. An endotracheal (ET) tube is put into your child's mouth or nose and attached to the ventilator.
    Proper Endotracheal Intubation
  • Nutrition support may be needed if your child cannot eat normally. Your child may not be awake, or he or she may have an ET tube that prevents him or her from eating. A feeding tube may be inserted. A feeding tube is a thin tube inserted through your child's nose or mouth into the stomach or small intestine. Formula can be injected through the feeding tube. Instead your child may need nutrition through an IV.
  • Pneumatic boots may be applied to your child's legs. The boots have an air pump that tightens and loosens different areas of the boots. This improves blood flow and helps prevent clots.
  • A blood transfusion may be needed if bleeding occurs or platelet levels drop. This can happen in severe sepsis.
  • Dialysis may be needed if your child's kidneys stop working correctly or are damaged during sepsis. Dialysis is a procedure to remove chemicals, wastes, and extra fluid from your child's blood.
  • Surgery may be needed to treat problems causing sepsis. This may include removing an abscess or infected tissue.

RISKS:

Without treatment, sepsis may develop into septic shock (sepsis with low blood pressure). Multiple organs may shut down. These problems can be life-threatening. Your child's organs may be permanently damaged by septic shock.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

© 2017 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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