Pediatric Sepsis

Hey everyone, it's Dr. Peter Entebbe. Thanks for joining me. Today's topic is sepsis. I wanted to really reaffirm to everyone that sepsis is a big killer in this country. It kills hundreds of thousands of people every year. And we're on the front line for sepsis. Now, the protocol does have a lot to do with adults and we know we have antibiotics for adults. But I wanted to reaffirm that there is a sepsis protocol for pediatrics, which is really the same thing minus the antibiotics. And so if you look at the protocol, it's an adult that's non pregnant, it's a patient who has a documented or suspected infection. And then you have to have two out of three of the hat criteria. So if you think about it, hypotension, altered mental status and tachypnea for the adult, well, it's the same thing, but it's age appropriate hypotension and age appropriate tachypnea in the pediatric patient with also the altered mental status. And so adult pediatrics sepsis, same exact thing. And I would really impress upon you that if you have a child who's hypotensive and altered, that child is septic. And I don't want you to think twice. I want you to go right ahead with the IV fluids. And then obviously if after the IV fluids it's not working, just like in the adult protocol, we have the ability to go to push press or epi. And of course, you know, that's 1ml per minute, it's at least 1ml every minute. So to get that blood pressure up to the appropriate point. So remember, the protocol is really the same, minus the antibiotics. Now, once you have that patient in the back of your rescue and you're suspecting sepsis and you're doing everything for this patient correctly, the important thing to know is these patients have to go to a comprehensive pediatric center. Remember, pediatric patients who have sepsis have a high rate of death, just like the adults who have sepsis. This is important. And maybe into the future, maybe in a year from now, we will be adding antibiotics. And so that protocol is going to look exactly the same. Adult and pediatrics sepsis is tough. We've all been fooled by it. And what do I mean by that? The kid's crying in the back of your ambulance. He's tachycardic because he's crying and he's breathing fast because he's crying. It's 2:00 in the morning, so he's sleepy and you're not thinking it's altered. You're thinking he's just tired. So what I will tell you is, even for myself, where I deal with this every single day, you will trick yourself and convince yourself that this kid is not septic. But use the data, use your criteria, and go for it. Because if you gave some fluids to a child who didn't really need it, I'm okay with that. But if you're not treating hypotension, and you're not addressing altered mental status, and you're taking the patient to the wrong facility, then we're going to end up in a situation where the child's is at the wrong place at the wrong time. And we know that time here is of critical importance for that patient's survival. Again, thank you guys for what you do. If you have any questions, let me know. Thank you very much.