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    Patent Pending

    Pediatric SIRS, Sepsis, and Septic Shock Criteria

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

    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.
    When to Use
    Pearls/Pitfalls
    Why Use
    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 »

    Result:

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    Next Steps
    Evidence
    Creator Insights

    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

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

    Critical Actions

    • Surviving Sepsis Campaign (2012) section on Pediatric Considerations reiterates the most recent PALS guidelines as described by Brierley and colleagues.
    • Historically pediatric sepsis management has been provider-dependent. More recently some hospitals and US states are instituting, studying, and fine-tuning standardized pediatric sepsis protocols.
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