Sepsis

Question 1

Who are high risk groups for sepsis?

Answer 1

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

Question 2

Differentiate between cold and warm shock.

Answer 2

• Cold shock
○ narrow pulse pressure and prolonged capillary refill
○ The underlying haemodynamic abnormality is septic myocardial dysfunction
○ more common in infants and neonates

• warm shock
○ wide pulse pressure and rapid capillary refill
○ The underlying haemodynamic abnormality is vasoplegia
○ more common in older children and adolescents.

Question 3

What might a septic workup consist of?

Answer 3

Bloods:
• FBE
• VBG
• Blood glucose
• UEC
• Blood culture

• Urine MCS
○ SPA up to 12 months in boys, up to 2 years in girls
○ Clean catch

• LP if not contraindicated (impaired conscious state, focal neurological signs, haemodynamic instability)
• CXR if suspicious about pathology

Question 4

When should you get IV access in for sepsis?

Answer 4

Within 15 mins

Question 5

What should you administer after full fluid resusc has been given?

Answer 5

• After 40ml/kg fluid resuscitation, give inotrope/vasopressor i.e. adrenaline for cold shock/noradrenaline for warm shock