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Sepsis In Children

WHAT YOU NEED TO KNOW:

Sepsis is a serious condition that occurs when your child's body overreacts to an infection. It is also called systemic inflammatory response syndrome (SIRS) with infection. An infection is usually caused by bacteria that attack the body. The body's immune system normally fights off an infection within the affected body part. With sepsis, your child's body overreacts and causes symptoms to occur throughout the body. This leads to uncontrolled and widespread inflammation and clotting in small blood vessels. Blood flow to different body parts decreases and may lead to organ failure. Sepsis requires immediate treatment.

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.

Reverse isolation:

Your child may be put in reverse isolation if his body is having a hard time fighting infections. Your child will be given a private room to protect him from other people's germs. Caregivers and visitors may wear gloves, a face mask, or a gown to keep their germs away from your child. Everyone should wash their hands when entering and leaving your child's room. Your child may be scared in isolation. Ask caregivers about the best ways to comfort your child while he is in isolation.

Medicines:

  • Antibiotics: This medicine is given to help prevent or treat an infection caused by bacteria.
  • Antifungals help treat or prevent a fungal infection.
  • Antiparasitic medicine: This medicine may be given to kill parasites. Parasites are living things that feed or eat off of other living things.
  • Antivirals help treat or prevent a viral infection.
  • Diuretics: This medicine may be given to help your child's body and lungs get rid of extra fluid. This can help your child breathe easier. Diuretics may make your child urinate more often.
  • Heart medicine: This medicine may be given to make your child's heart beat stronger or more regularly. There are many different kinds of heart medicines. Talk with caregivers to find out what your child's medicine is and why he is taking it.
  • Glucose or insulin: The amount of sugar in your child's blood may be increased with glucose or decreased with insulin. This helps control your child's blood sugar and keep it within the normal range.

Monitoring:

  • Blood sugar checks: Your child's blood sugar may be checked many times each day. Your child's finger is pricked to draw blood and the blood is put into a glucose monitor (glucometer). A glucometer is a small handheld machine used to test the amount of sugar in your child's blood.
  • Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your child's skin record the electrical activity of his heart.
  • Intake and output: Your child's healthcare providers may monitor how much food and liquid your child takes in and puts out. Your child may need any of the following:
    • Intake and output may be measured. Healthcare providers will keep track of the amount of liquid your child is getting. They also may need to know how much your child is urinating. Ask healthcare providers if they need to measure or collect your child's urine.
    • Foley catheter: This is a tube that may be put into your child's bladder to drain his urine into a bag. The catheter will be taken out when your child is better.
  • Neurologic signs: These are also called neuro signs, neuro checks, or neuro status. During a neuro check, caregivers see how your child's pupils react to light. They may check his memory and how easily he wakes up. His hand grasp and balance may also be tested. How your child responds to the neuro checks can tell caregivers if his illness or injury has affected his brain.
  • Pulse oximeter: 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 your child's foot, toe, hand, finger, or earlobe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your child's oxygen level is low or cannot be read.
  • Arterial line: This tube is also called an "art line" or an "A-line". It is placed into an artery, usually in the wrist or groin. The groin is the area where your child's abdomen (belly) meets his upper leg. The art line is attached to tubing with liquid in it. This liquid helps keep the tubing from getting plugged. The tube may be used for measuring your child's blood pressure or for drawing blood.
  • CVP line: A CVP line is also called a central line. It is an IV catheter or tube. It is put into a large blood vessel near your child's neck, groin, or near his collarbone. The CVP line may be used to give medicines, draw blood, or to check your child's heart.
  • Vital signs: Caregivers will check your child's blood pressure, heart rate, breathing rate, and temperature. They will also ask you or your child about his pain. These vital signs give caregivers information about your child's current health.

Tests:

  • Culture: This is a test to grow and identify the germ that is causing your child's sepsis. A culture may be done using your child's blood, urine, or brain and spinal cord fluid. Samples may also be taken from wounds or sores. This test helps healthcare providers know what kind of infection your child has and the best medicine to treat it.
  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your child's heart.
  • Blood gases: These tests are also called arterial blood gases (ABGs). Blood is taken from an artery usually in your child's wrist. ABGs may be done if your child has trouble breathing or other problems caused by his illness.
  • Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.
  • Lumbar puncture: This procedure may also be called a spinal tap. A small needle is placed into your child's lower back. Fluid will be removed from around your child's spinal cord and sent to the lab for tests. The test is done to check for bleeding around your child's brain and spinal cord, and for infection. This procedure may also be done to take pressure off your child's brain and spinal cord, or to give medicine. Your child may need to be held in place so that he does not move during the procedure.
  • Urine sample: A sample of your child's urine is collected and tested for infection.
  • X-rays: X-rays of different parts of your child's body may be taken. These may include x-rays of the chest (lungs and heart) or abdomen. X-rays may help healthcare providers look for infections or signs of other problems. Your child may have more than one x-ray taken for tests.

Treatment:

  • Blood transfusion: During a blood transfusion, your child will get whole blood, or parts of blood through an IV. You may be worried that your child will get AIDS, hepatitis, or West Nile Virus from a blood transfusion. The risk of this happening is rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile Virus.
  • Dialysis: Dialysis cleans your child's blood when the kidneys cannot. Extra water, chemicals, and waste products are removed from your child's blood by a dialyzer or dialysis machine. The dialysis machine does this by passing the blood through a special filter, then returning it back to your child. Your child may need dialysis for a short time or for the rest of his life. Healthcare providers will check your child's vital signs, such as blood pressure and pulse, often during dialysis. He may also be given medicines or have blood taken for lab tests during dialysis.
  • Exchange transfusion: This procedure may be done to babies with septic shock. Healthcare providers remove and replace some of your baby's blood with donor blood. Donor blood comes from the blood bank.
  • Extracorporeal membrane oxygenation: This is also called ECMO. A machine is used to put oxygen into your child's blood. Healthcare providers may use this to help support your child while his heart or lungs are recovering. This may also be used if other treatments, such as dialysis, do not work.
  • Respiratory support:
    • Your child may need extra oxygen if his blood oxygen level is lower than it should be. Your child may get oxygen through a mask placed over his nose and mouth or through small tubes placed in his nostrils. Ask your child's healthcare provider before you take off the mask or oxygen tubing.
    • ET tube: Your child may need an endotracheal (ET) tube to help him breathe. An ET tube is put in your child's mouth or nose, and goes into the trachea (windpipe). It may be connected to a breathing machine called a ventilator. The ET tube will be taken out when your child is breathing better.

Diet:

Your child may not be able to eat food for a period of time. Your child may be given high-calorie feeding or total parenteral nutrition (TPN). TPN provides your child's body with protein, sugar, vitamins, minerals, and sometimes fat. TPN is usually given through an IV catheter.

RISKS:

If left untreated, sepsis may cause your child's blood pressure to drop to very dangerous levels. His kidneys, lungs, brain, and other organs may be affected and later stop working. These problems can be life-threatening.

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.

© 2016 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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