NICE Paediatric Sepsis Overview: Triggers Antibiotics and Fluids Discussion
MEM-EM: The Memorising Emergency Medicine Podcast16 Mars

NICE Paediatric Sepsis Overview: Triggers Antibiotics and Fluids Discussion

Executive Summary

The primary mission in the Emergency Department (ED) is the rapid identification of life-threatening organ dysfunction. Clinicians must maintain a high index of suspicion, asking "Could this be sepsis?" for any patient presenting with signs of infection.

  • Critical Window: For patients meeting any High Risk criteria, a senior clinical decision maker (ST4+) must assess the patient, and broad-spectrum antibiotics must be administered within one hour.
  • Risk Stratification: Risk is graded as High, Moderate-to-High, or Low based on age-specific criteria across behavior, respiration, circulation, and skin appearance.
  • Key Interventions: Initial management focuses on the "Sepsis Six" principles: high-flow oxygen (if SpO2 <92% or shocked), blood cultures and investigations, intravenous (IV) antibiotics, and weight-based fluid resuscitation.
  • Safety Netting: Patients not meeting high-risk criteria must still be reviewed by a clinician within 1–3 hours depending on the number of moderate-to-high risk markers.
  • Sepsis: Life-threatening organ dysfunction caused by a dysregulated host response to infection [1].
  • Suspected Sepsis: Individuals presenting with signs or symptoms indicating possible infection who require face-to-face assessment and potential urgent intervention [1].

Definition and Classification

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