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Sepsis, Pediatric

Erik R. Hoefgen, MD, MS and Craig H. Gosdin, MD, MSHA Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Systemic inflammatory response syndrome (SIRS): nonspecific inflammatory response, defined as at least two of the following four criteria (one of which must be either abnormal temper...

DIAGNOSIS

Requires high suspicion; fever and tachycardia are nonspecific and hypotension is generally a late sign. 

HISTORY

  • See “Risk Factors.”

  • Duration of illness before presentation

    • Abrupt onset of symp...

TREATMENT

ALERT
  • Rapid recognition of sepsis is critical.

    • Fluid resuscitation targeting cap refill ≤2 seconds, normalized BP for age, normal peripheral pulses, and urine output >1 mL/kg/h within 6 hou...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Admit all patients with suspected sepsis to the hospital; consider ICU admission.

  • Continuous BP monitoring for the development of refractory shoc...

ADDITIONAL READING

  • Bateman SL, Seed PC. Procession to pediatric bacteremia and sepsis: covert operations and failures in diplomacy. Pediatrics.  2010;126(1):137–150. [View Abstract on OvidInsight...

CODES

ICD9

  • 995.91 Sepsis

  • 995.90 Systemic inflammatory response syndrome, unspecified

  • 995.92 Severe sepsis

  • 785.52 Septic shock

  • 038.42 Septicemia due to escherichia coli [E. coli]

  • 771.81 Septicemia [sepsis] o...

FAQ

  • Q: What are the early clinical signs of sepsis?

  • A: Vital sign changes such as tachycardia, tachypnea, along with respiratory distress/hypoxia and central nervous system alterations can be early sig...

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