Septicaemia
The common causes in neonates are Group B strep and Listeria.
The common causes in children are S.pneumoniae, N.meningitidis, and S.aureus.
In Septic Shock, there's cardiovascular dysfunction in which the BP drops → Hypoperfusion → Raised Lactate.
Presentation
Poor feeding
Inconsolable crying
Altered mental state – e.g. sleepiness, irritability, lethargy, floppiness
Pale or mottled skin
O/E - Increased WOB, Tachycardia, Fever or hypothermia, Prolonged CRT, Non-blanching rash (very worrying sign, and puts the child at high risk)
Management - SEPSIS 6
High-flow O2
Get IV/IO access and take:
Blood Cultures
Bloods – Glucose, FBC, U&E, CRP, INR
Blood Gas – Lactate, Acidosis
Give IV/IO Abx – Broad-spectrum
IVF – 20ml/kg IV bolus of 0.9% Saline over 5-10 mins if Lactate > 2mmol/L or Shock
Repeat if necessary and aim for normal physiological parameters
Involve seniors early
Consider Inotropic support early if normal physiological parameters aren’t reached after >40ml/kg of Fluids