A spotlight on sepsis

A spotlight on sepsis



What is sepsis?

Sepsis can also be known as septicaemia, blood infection or blood poisoning. It occurs when what may be a simple infection progresses throughout the body and the body’s response to an infection damages its own organs and tissues.

Sepsis can be caused by any type of infection – bacterial, viral or fungal. It can lead to tissue damage, multiple organ failure and death. Septic shock is the most serious form of sepsis.

Who can get sepsis?

Both adults and children can get sepsis and any kind of infection can lead to sepsis.  

Children and newborns have a higher risk of sepsis compared to adults. The risk can be higher in:

  • Children under 1 year of age
  • Aboriginal and Torres Strait Islander children
  • Children with complex health conditions
  • Children with COVID-19
  • Children with poor immune systems
  • Children undergoing chemotherapy
  • Children with burns, wounds or injuries
  • Children with indwelling devices, lines or catheters
  • Children who have just had surgery or another procedure
  • Children who have been previously diagnosed with sepsis

What are the signs and symptons of sepsis?

As sepsis can develop from common infections, the early signs and symptoms may be mild and similar to the underlying infection. The signs can be vague, without any specific features that stand out from other illnesses. This makes diagnosis challenging, especially in newborn babies. The difference with sepsis is that your child will become more severely ill. The symptoms listed below can be a sign that more severe disease is present.

When a child has sepsis, their parents often feel that their child is very unwell or worried that they are not improving – this is important information. You know your child best. Let a doctor or nurse know if you are worried that your child is very sick or getting worse, especially if you know they have an infection.

It’s important for you to ask: ‘Could it be sepsis?’

The signs and symptoms may look different in younger children compared with older children. Infants and newborns commonly have non-specific symptoms and signs, such as feeding difficulties or not settling.

Common sepsis signs in children

  • Fast breathing or long pauses in breathing
  • Blotchy or discoloured skin
  • Skin that is abnormally cold to touch
  • Rash that doesn’t fade when pressed
  • Infrequent wet nappies
  • Drowsiness – the child is difficult to wake up or confused
  • Restlessness or floppy limbs
  • Vomiting
  • Fits or convulsions
  • A lot of unexplained pain

What should I do if my child has symptoms of sepsis?

Sepsis is a medical emergency. If you think your child may have sepsis, you need to go to hospital or call 000. If your child does have sepsis, they will be more likely to get better if they receive treatment as soon as possible.

If your child has signs and symptoms of sepsis when they see a healthcare provider, or if they develop signs and symptoms during a hospital stay, the healthcare team will carry out physical checks such as taking their temperature and blood pressure and doing blood tests. These tests can help your child’s healthcare team to understand their condition, but there is no single laboratory test for sepsis.

What is the treatment for sepsis?

If sepsis is suspected, your child’s clinical team may:

  • Place an intravenous cannula in a vein
  • Take small samples for blood cultures to test for infections in the blood; blood cultures can take 48hours to give a result
  • Start antimicrobials (usually antibiotics) immediately, while waiting for blood culture results
  • Give intravenous fluids and other medicines to support your child’s circulation
  • Monitor their response to treatment
  • Consult with other clinicians who are experienced in recognising and managing sepsis
  • Arrange for transfer or admission to the most appropriate place for your child’s care

Sepsis affects every child differently, and the care required depends on the severity of the illness. Your child may require a hospital stay, or admission to a paediatric intensive care unit.

Your healthcare team should talk to you throughout your child’s admission about:

  • What a diagnosis of sepsis means for your child in the short, medium and longer term
  • Plans for your child’s treatment during the hospital stay and who will provide this care
  • What to expect as your child recovers in hospital after the initial critical care for sepsis
  • How you can escalate care (that is, increase the level of care) if you are concerned
  • Support you can receive in hospital

Remember that you and your family should be informed about your child’s treatment options and involved in decisions about their care.

Let your healthcare team know if you need a translator or interpreter; they can help to arrange this. If you identify as Aboriginal or Torres Strait Islander, an Aboriginal and Torres Strait Islander liaison officer can meet with you if you wish.

Dealing with a complex health issue like sepsis can be stressful and challenging. Let your healthcare team know if you or a family member need support, such as from a social worker.

Leaving hospital is not the end of the journey. Depending on the situation, your child may need support from several clinicians to get back to the level of physical and mental wellness they had before the sepsis diagnosis. These can include:

  • Nurses
  • Paediatricians
  • Physiotherapists
  • Occupational therapists
  • Neuropsychologists or cognitive behavioural therapists
  • Speech pathologists
  • Dietitians
  • One or more specialist doctors.

When your child is discharged from hospital, their healthcare team will give you a discharge summary that gives important information about the care your child received in hospital and the care they will need afterwards, including their medicines and required appointments.

What happens when you child is back home?

Sepsis can affect many organs in the body and affects everyone differently. Children can make a full recovery however it may take some time, before they are well enough to return to day care or school.

Some children experience physical symptoms such as headaches and other pain, tiredness, difficulties sleeping, changes in appetite, and changes in muscle tone or weakness. Children can also suffer cognitive and psychosocial symptoms, including changes in behaviour, changes in concentration and fear of medical treatments.

Some children can experience long-lasting physical, cognitive and psychological effects.

This is called ‘post‑sepsis syndrome’. We are still learning how children are affected by post-sepsis syndrome.

Your child’s healthcare team can help you to manage any ongoing effects of sepsis and can refer you to other medical specialists or healthcare providers if necessary.

Preventing sepsis in the future

Children who have had sepsis have an increased risk of having sepsis again in the short term. This is thought to be due to changes in the immune system caused by sepsis. Infections cannot always be avoided, so if your child does develop an infection, monitor them for signs of sepsis and go to your GP or to hospital if you are concerned.

To reduce the risk of infections (and sepsis):

  • Keep up to date with your child’s vaccinations (including COVID-19 and influenza, if applicable) to prevent infections
  • Support your child to take care with basic hygiene measures such as washing hands regularly with soap and water
  • Pay close attention to insect bites and skin injuries; see a doctor if they are not healing, or become red, hot or inflamed
  • If an infection occurs, visit your GP; ensure that your child takes any medicines prescribed as directed
  • Let healthcare providers know of your child’s past sepsis diagnosis if you go to hospital or to see a doctor
  • Be aware of the early symptoms of sepsis, and do not hesitate to call an ambulance if you are concerned about sepsis. Just ask: ‘Could it be sepsis?’ Early treatment saves lives.
  • If your child has a pattern of being unwell, remember to remain vigilant as although their norm may be to have fevers that you manage at home, any change may be significant requiring hospitalisation and antibiotics especially where a temperature of greater than 38C occurs or the symptoms mentioned above.

More information about sepsis

The Sepsis Clinical Care Standard provides guidance to clinicians and healthcare services, and information for patients about the care they can expect to receive if they have sepsis.

Sepsis resources

The following resources can help families of children who have had sepsis.

Peer support groups include:

In case of limb amputation: