Approach to assessing sepsis or septic shock in children 1 month or older

In children 1 month or older, standard observations (eg respiratory rate, blood pressure) and signs of life-threatening organ dysfunction vary according to the patient’s age; age-appropriate standard observation charts are available in most jurisdictions. Clinical features can be nonspecific and include signs that are not typical of sepsis in older patients (eg gasping, grunting, increased irritability or lethargy, inability to feed or eat). Meningitis must be considered in young children presenting with nonspecific signs of sepsis, because classical signs are often absent. A lumbar puncture may be required to exclude meningitis; seek expert advice from a senior clinician to determine whether a lumbar puncture is required. Consider sepsis in children when their clinical state is causing significant concern to family or clinical staff. Detailed information on recognising sepsis in children is not covered in these guidelines.

Age-appropriate sepsis management pathways are available in some jurisdictions. If local guidelines are not available to guide antibiotic therapy, see Choice of empirical antibiotic regimen for sepsis or septic shock.