Spotting the warning signs of sepsis in children, at an early stage

93Every year a number of children die from severe and sudden infections in situations that could have been avoided if their condition had been recognised and treated earlier.

Although guidelines exist for the treatment of sepsis, spotting sepsis in children is very difficult. The difficulty is that it is rare so may not be encountered that frequently and the signs can easily be confused with other conditions. To combat this a working group led by Jeremy Tong, now Consultant Paediatric Intensivist at the University Hospitals of Leicester, developed the Paediatric Sepsis 6, a tool modelled on the already-existing adult version. This aims to give clinicians the information they need, in readily accessible form, to help spot the warning signs of sepsis at an early stage.

The tool has been promoted via social media and was rolled out across Scotland as well as at Birmingham Children’s Hospital. Dr Tong continued to raise awareness across the hospital, particularly among those clinicians, such as triage staff, junior doctors and bedside clinical staff, who are likely to be the first point of contact for severely ill children. To do this, he and his colleagues developed a “power training” education programme which involved teaching small groups of ward nurses about the new tool. Over a two-week period this intensive programme reached around 70% of the hospital’s intensive care unit’s 300 staff.

They also sought to raise awareness with Sepsis 6 cards which staff are encouraged to attach to their lanyards. A Picu Sepsis box contains the information and equipment needed if a child is believed to be suffering from sepsis.

“The tool is designed to help people make the right choices,” explained Dr Tong. “Rather than missing sepsis because people aren’t thinking about it, it’s about saying: ‘OK this child is unwell and they could have sepsis. Just think about it and go back and make sure you don’t miss it’.

“The key thing that will make a difference is earlier recognition and earlier treatment because all the data indicates that the earlier you treat, the better the outcomes can be.”

Birmingham Children’s Hospital is now working at implementing this across the whole site and there are a number of other trusts who are looking at using the Paediatric Sepsis 6 as a model for their paediatric sepsis pathway.

For further information about Paediatric Sepsis 6, visit the UK Sepsis Trust website.
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