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Pediatric SIRS, Sepsis, and Septic Shock Criteria

Defines the severity of sepsis and septic shock for pediatric patients.

Note: There is still debate about how to define pediatric sepsis given varying ranges of “normal” vital signs for ages. For patients over 18, please use the Adult SIRS, Sepsis, and Septic Shock Criteria.
SIRS Criteria (≥ 2 meets SIRS definition, 1 of which must be abnormal temperature or leukocyte count)
List of Age-Dependent Vital Sign Ranges Available in About Section
Sepsis Criteria (SIRS + Source of Infection)
Severe Sepsis Criteria (Sepsis + ≥ 1 following Dysfunction Criteria)
Organ Dysfunction Criteria »
Septic Shock Criteria (Sepsis + Cardiovascular Dysfunction)
Organ Dysfunction Criteria »

Management

  • Much of the current practice in pediatric sepsis screening are applied from the adult literature, and therefore not directly evidence-based.
  • Similar to adults, Those with a suspected/confirmed infection with hemodynamic instability should immediately be treated for Septic Shock without waiting for laboratory confirmation.
  • Similar to adults, early IV fluids and broad-spectrum antibiotics seem to be the most critical actions.
  • IV fluid recommendations include repeated 20cc/kg boluses of isotonic crystalloid or colloid over 5-10 minute intervals.
  • Consider consulting an ICU when severe sepsis / septic shock is identified.

Pediatric Advanced Life Support (PALS) 2011 Algorithm for Septic Shock