Sepsis

What Is Sepsis?

Sepsis is a medical emergency that needs treatment right away. When the body gets an infection, the immune system fights it. Sepsis happens when the immune system goes into overdrive and damages the body's own organs and tissues. It can cause the blood pressure to fall way below normal, called septic shock. This can happen when the body is fighting any kind of infection.

Sepsis can damage the kidneys, lungs, brain, heart and the blood clotting system that stops bleeding. It can even cause death. By knowing the signs of sepsis, parents can get their children medical attention early, which can make treatment work better.

Top Things to Know About Sepsis

• Sepsis is a medical emergency that needs prompt treatment.
• Sepsis happens when the immune system overreacts when fighting an infection and damages the body's organs.
• Protect your family against sepsis by doing what you can to prevent infections:
  • Make sure your kids get all recommended vaccines.
  • Everyone should wash their hands well and often.
  • Know how to clean and care for cuts and scrapes.
• If your child is sick and not getting better, call your doctor or get medical care. If your child is prescribed antibiotics, give all doses exactly as directed.
• Trust your instincts and speak up. You know your child best. If your child seems sicker than usual to you, or has an infection that doesn't get better or gets worse, call the doctor or get medical help right away. Ask the doctor, "Could it be sepsis?"

What Are the Signs & Symptoms of Sepsis?

Sepsis can be very hard to identify. Many of its signs are also common in routine childhood illnesses. But trust your instincts. If your child seems sicker than usual or something just doesn't seem right, call the doctor or get emergency medical care right away.

Having one sign alone doesn't mean a child has sepsis. But when a few of these things happen together, that's a clue that sepsis is possible:

• fever, shivering, or a very low temperature
• fast, shallow breathing
• fast or racing heartbeat, especially if they don’t have a fever at that time
• sweaty, blotchy, or pale skin
• peeing less than usual
• extra sleepiness, trouble waking up, or confusion
• complaining of bad pain (babies and very young kids might just cry a lot)

What Causes Sepsis?

Sepsis starts with an infection caused by a germ. Bacteria, viruses, fungi, and parasites are types of germs that can cause sepsis.

When the body has an infection, it makes chemicals to fight it. Usually those chemicals stay in the location of the infection. During sepsis, the chemicals get into the bloodstream and spread, damaging the body's organs.

Who Is at Risk for Sepsis?

Sepsis can affect people of any age. But some people have a higher risk for it, such as:

• infants less than a year old, especially babies less than a month old or born early (premature)
• adults 65 or older
• people with chronic medical conditions
• people with a medical device (like a catheter or long-term IV line)
• people who just had surgery or a major trauma
• people whose immune systems are weak from conditions such as HIV or cancer, or from medicines that treat a health problem by blocking the immune system

How Is Sepsis Diagnosed?

No specific test can tell for sure that someone has sepsis. The medical team puts together clues from the patient's medical history, symptoms, an exam, and tests to make a sepsis diagnosis.

Tests done can include:

• lab tests, like blood tests or urine (pee) tests
• radiology tests, like X-rays, an ultrasound, or a CT scan

The tests can look for an infection that could be causing sepsis and check for organ damage.

How Is Sepsis Treated?

Sepsis is treated in the hospital, where doctors can closely watch the patient. Some children must get care in the pediatric intensive care unit (PICU) for extra monitoring and treatment.

Monitors like a cardiorespiratory monitor and pulse oximetry watch the heart and breathing. Doctors watch the child's blood pressure closely. Sometimes a special monitor, called an arterial line (or A-line, for short), measures blood pressure constantly from inside the arteries.

The patient will get antibiotics to fight the infection through an intravenous (IV) line, which is a small tube put into a vein. Usually, doctors start antibiotics right away — even before the diagnosis of sepsis is proven.

Kids also will get fluids through the IV and, if needed, blood pressure medicines called vasopressors to keep the heart working well. Some kids with sepsis might need extra blood or to get some parts of blood through the IV. This is called a blood transfusion and can help the blood make clots or carry oxygen better.

Sometimes, a child needs a special IV called a central line. This bigger IV line goes into a larger vein that can carry the needed medicines and fluids faster.

Kids with sepsis could need help breathing. If so, doctors give oxygen or might place a breathing tube and use a ventilator (a machine that helps with breathing). If the heart and lungs are too sick to get enough oxygen to the body, the medical team may use a treatment called ECMO. This is where a machine takes over for the heart and lungs so the body can heal.

Kids with sepsis might have kidney damage and stop making urine (pee). Doctors use dialysis to clean the blood when the kidneys can't do that.

What Else Should I Know?

It's not always possible to prevent sepsis. But preventing infections can help lower the chances of sepsis.

To help protect your kids from infection:

• Get your kids their vaccines on the recommended schedule. They help prevent bacteria and viruses from causing infections that can lead to sepsis.
• Encourage regular hand washing.
• Clean any cuts or scrapes well. Keep a close eye on them to be sure they're healing as expected.
• If your child has a medical device (like a catheter or long-term IV line), follow the doctor's directions for cleaning and using it.

If your child is sick and not getting better, call your doctor or get medical care. If your child is prescribed antibiotics, give all doses exactly as directed.

Most important: Call the doctor or get medical help right away if your child:

• seems sicker than usual to you
• is being treated for an infection that's not getting better or gets worse

Ask the doctor, "Could it be sepsis?"