Sepsis

What is sepsis?

Sepsis happens when an infection spreads and causes the body to react strongly to germs, usually bacteria. The body’s defense system normally releases chemicals to fight off infection at the infected area. Due to the spread of infection in sepsis, chemicals are released throughout the body. The chemicals cause inflammation and can cause clotting in small blood vessels that is difficult to control. Inflammation and clotting decreases blood flow and oxygen to organs. This may cause them to stop working correctly. Sepsis is also called systemic inflammatory response syndrome (SIRS) due to infection.

What increases my risk for sepsis?

• An infection anywhere in your body.
• Treatment in a hospital for a serious illness or having an implanted catheter.
• Being very young or very old.
• Chronic conditions such as COPD, heart failure, or diabetes.
• A weakened immune system from a long-term condition or medicine.
• A recent surgery.
• Severe injuries, such as large burns.

What causes child sepsis?

Any kind of infection in the body can trigger sepsis. The following may put your child at a higher risk for sepsis:

• Malnourishment (poor nutrition).
• Premature birth (before 37 weeks) or birth more than 18 hours after the mother’s bag of water broke.
• A weak immune system.
• Heart defects, urinary tract problems, large burns, or multiple injuries.
• Age less than 2 years, especially newborns.
• Hospital stays, especially in the intensive care unit (ICU) for a long time or after having a surgery.
• Medicines that decrease the body’s ability to fight infections.

What are the signs and symptoms of sepsis?

• Fever or very low body temperature.
• Chills or severe shaking.
• Extreme weakness.
• Fast or irregular heartbeat.
• Fast or difficulty breathing.
• Confusion, loss of consciousness, or a seizure.
• Urinating very little or not at all.

What are the signs and symptoms of child sepsis?

• Fever, hypothermia (very low body temperature), or seizures.
• Eating, drinking, sucking poorly, or vomiting.
• Fast or slow heart rate.
• Fast breathing or trouble breathing.
• Urinating very little or not at all.
• Weakness, irritability, drowsiness, and harder to wake than normal.

How can child infections be prevented?

The following are ways that you can help prevent infection, which can lead to sepsis:

• Have your child checked by his or her healthcare provider if he or she often gets lung, sinus, or skin infections. This may help prevent more serious problems.
• Have your child vaccinated against different infections caused by viruses or bacteria, such as the flu virus.
• Keep your child away from people with infections, such as those with a cough and colds.
• Wash your child’s hands and your hands often with soap and water.
• If your child has a weak immune system, ask his or her healthcare provider if there are other things you can do to help prevent infection.

How is sepsis diagnosed?

• Measurement of your vital signs may show an abnormal temperature, heart rate, or blood pressure.
• Blood and urine tests will show infection, organ function, and give information about your overall health. They may also show what germ is causing your infection.
• An X-ray, ultrasound, CT, or MRI may show where in your body the infection came from. You may be given contrast liquid to swallow or in your IV to help the infection, show up better in the pictures. Tell your healthcare provider if you have ever had an allergic reaction to any type of contrast liquid. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if you have any metal in or on your body.

How is sepsis treated?

Several treatments may be needed if sepsis causes one or more organs to stop working correctly. Treatments are often started in the emergency room and continued in an intensive care, or critical care unit of a hospital. You may need any of the following:

• Medicines may be given to increase your blood pressure and blood flow to your organs. Medicines may also be given to decrease inflammation, control your blood sugar, prevent stomach ulcers, and prevent blood clots. Antibiotics may be given to treat an infection.
• Removal or change of a catheter or drain may be needed to get rid of the infection.
• Nutrition support may be needed if you cannot eat normally. During sepsis you may not be awake, or you may have a breathing tube that prevents you from eating. A feeding tube may be inserted. A feeding tube is a small, thin tube that is inserted through your nose or mouth into your stomach or small intestine. Formula can be injected through the feeding tube and give you nutrition. You may instead need nutrition through your IV.
• A blood transfusion may be needed if bleeding occurs or platelet levels drop. This can happen in severe sepsis.
• Dialysis may be needed if the kidneys stop working correctly or are damaged during sepsis. Dialysis is a procedure to remove chemicals, wastes, and extra fluid from your blood.
• Surgery or other procedures may be needed to treat problems causing sepsis. This may include draining an abscess or removing infected tissue.

When should I seek immediate care for sepsis?

Call 911 or have someone else call for any of the following:

• You have any of the following signs of a heart attack:
  • Squeezing, pressure, or pain in your chest that lasts longer than five minutes or returns.
  • Discomfort or pain in your back, neck, jaw, stomach, or arm.
  • Trouble breathing.
  • Nausea or vomiting.
  • Lightheadedness or a sudden cold sweat, especially with chest pain or trouble breathing.
• You have a seizure or lose consciousness.
• You have trouble breathing.
• Your lips or fingernails are blue.
• You feel extremely weak and have a hard time moving.
• You have been diagnosed with an infection and your symptoms, such as fever, get worse.
• You have increased swelling in your legs, feet, or abdomen.
• You stop urinating or urinate a lot less.

When should I seek immediate care or call 911 for my child’s sepsis?

• Your child is coughing hard or coughing up blood.
• Your child has a high-pitched cry.
• Your child has trouble breathing, or his lips and fingernails are pale or turning blue.
• Your child is not able to eat, suck, or drink, or is urinating less or not at all.
• Your child looks very tired or weak, or he is more fussy or sleeping more than usual.
• Your child passes out or has a seizure.
• Your child’s bowel movement or vomit has blood in it.
• Your child’s symptoms do not improve or get worse.

When should I contact my child’s healthcare provider?

• Your child has a fever.
• Your child’s skin is itchy, swollen, or has a rash.
• You have questions or concerns about your child’s condition or care.