Clinical Practice Guidelines

SEPSIS – assessment and management

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    This guideline has been adapted for statewide use with the support of the Victorian Paediatric Clinical Network

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    Background to condition

    Septic children may present with:

    • warm shock characterised by a wide pulse pressure and rapid capillary refill
    • cold shock characterised by a narrow pulse pressure and prolonged capillary refill.

    Note: The type of shock may change during resuscitation and needs to be continuously reassessed. 

    Early recognition and antibiotic administration has been shown to improve survival.

    Children at increased risk of severe sepsis include:

    • Neonates
    • Immunosuppressed children
    • Children with central venous access devices

    Fluid resuscitation should be judiscious; inadequate as well as excessive fluid resuscitation may be harmful.

    If, after assessment, you do not think that the patient is septic, refer Febrile child guideline. If you are unsure whether a child may have early signs of sepsis, senior clinician (or paediatrician on-call) review is necessary.


    Assessment and management 

    PDF version of assessment and management of sepsis algorithm 

    When to consider transfer

    • Any child who has received 40ml/kg or more of IV fluids as a bolus should be discussed with NETS/PETS. Contact Sick Kids Hotline (03) 9345 7007.
    • Child requiring care beyond the comfort level of the hospital. 
    Information specific to RCH - Including who to consult for inpatients.
    If you are worried about the patient ring ICU x55211 / PICU outreach registrar x52327 / or call a MET 777.

    For emergency advice and paediatric or neonatal ICU transfers, call the Paediatric Infant Perinatal Emergency Retrieval (PIPER) Service: 1300 137 650.