Clinical update

Sepsis in children: how to spot the signs

Institute of Health Visiting’s latest resource helps parents recognise the symptoms of sepsis in a child

Institute of Health Visitings latest resource helps parents recognise the symptoms of sepsis in a child

Although not all fevers in children are life-threatening, new guidance recommends that parents recognise the symptoms of sepsis and when to get emergency care. Picture: iStock

Essential information

Sepsis is a rare, life-threatening condition arising when the bodys response to infection causes injury to its own tissues and organs. National Institute for Health and Care Excellence (NICE) guidance states that the condition is difficult to diagnose with certainty. Signs and symptoms can be non-specific and although there may be a history of infection, fever is not always present.

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Institute of Health Visiting’s latest resource helps parents recognise the symptoms of sepsis in a child

Mother checking a child's temperature. Although not all fevers in children are life-threatening, new guidance recommends that parents recognise the symptoms of sepsis and when to get emergency care
Although not all fevers in children are life-threatening, new guidance recommends that parents
recognise the symptoms of sepsis and when to get emergency care. Picture: iStock

Essential information

Sepsis is a rare, life-threatening condition arising when the body’s response to infection causes injury to its own tissues and organs. National Institute for Health and Care Excellence (NICE) guidance states that the condition is difficult to diagnose with certainty. Signs and symptoms can be non-specific and although there may be a history of infection, fever is not always present.

Most often caused by bacterial, viral or fungal infections, sepsis can occur in anyone at any time, affecting any part of the body, says Public Health England (PHE). Without quick and timely treatment, it can lead to septic shock, multi-organ failure and death.

PHE guidance states children with pneumonia, urinary tract infections, meningitis and severe skin infections can rapidly deteriorate and develop sepsis.

What’s new?

In September, the Institute of Health Visiting (IHV) launched its updated guidance, Recognising Sepsis in a Child, as part of its parent tips series of factsheets, which provide advice on looking after a baby from birth until they go to school. This factsheet outlines what sepsis is; describes red flag symptoms; provides helpful pointers; and suggests further reading.

RCNi’s sepsis resource collection

Key information

Children who are most susceptible to life-threatening infections that may lead to sepsis include:

  • Those under one year
  • Children who are immunocompromised, including those having chemotherapy, are diabetic, or have sickle cell disease
  • Those taking long-term steroids
  • Children who have had surgery or invasive procedures in the previous six weeks
  • Those with a breach of skin integrity, such as cuts, burns, blisters or infections
  • Children with indwelling lines or catheters

According to the iHV guidance the following symptoms need emergency action, either calling 999 or going straight to an emergency department (ED), if the child:

  • Looks mottled, bluish or pale
  • Is very lethargic or difficult to wake
  • Feels abnormally cold to touch
  • Is breathing very fast
  • Has a rash that does not fade when you press it
  • Has a fit or convulsion

How you can help your patient

Remind parents that not all fevers in children will develop into serious or life-threatening conditions. Reassure them they can be safely cared for at home, as long as they are aware of the symptoms of sepsis, calling 999 or going to an ED if they spot anything concerning.

If a child is unwell, advise parents to check on them regularly during the day and night. It is also important to give regular fluids to children, including breastmilk. Liquid paracetamol and ibuprofen are safe medicines to use if a child has pain or fever, but make sure parents understand and follow advice and instructions, including the right dose for the child’s age.

Expert comment

Alison Morton, deputy executive director, Institute of Health Visiting

Alison Morton, deputy executive director, Institute of Health Visiting

‘The world’s attention is on COVID-19, but there are concerns other illnesses are being ignored. The coronavirus presents a minimal risk for children while sepsis can present a much higher risk of harm, especially for infants aged one year or under.

‘For parents, an important message is that sepsis can be prevented, through immunisation, good hygiene, not overlooking the signs and seeking prompt emergency treatment if any are recognised.

‘Most children’s conditions are minor and will respond to store cupboard treatments that parents can provide. But parents also need to be aware of what might be worrying, keeping an eye out for any changes. Our guidance will help parents strike a balance, putting their minds at rest because their baby doesn’t have any concerning symptoms, but also allowing them to take the initiative if they are anxious, quickly seeking professional help.’

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