Sepsis warning symptoms and sepsis management will be the subject of a debate today at the Royal College of Nursing’s (RCN) annual Congress in Liverpool where nurses will call for a nationwide rollout of a new system to enable signs of deterioration in any patient’s condition to be identified and acted upon quickly. 

If healthcare staff and the public are better educated on the signs of sepsis tens of thousands of lives lost each year could be saved. According to the UK Sepsis Trust between 1,000 and 4,000 under-fives die of sepsis every year in the UK. Yet there is not currently a universal, nationally validated system to identify deterioration in child patients.

Dame Donna Kinnair, RCN Chief Executive & General Secretary, said: "Sepsis in a child is so sudden. You can see a child who comes in looking like they have a common cold. You might send that child home. In a matter of an hour, you see the child develop the symptoms of sepsis that are very clearly defined.

"By the time they have developed the stark symptoms of sepsis there's no way you can come back from that. It's really important that we get a way of ensuring that we diagnose this accurately.”

Signs of sepsis in children

The signs and symptoms of sepsis can include a combination of any of the following:

  • Fever or low temperature (newborns and infants may have low temperature)

  • Fast heart rate

  • Fast breathing

  • Feeling cold/cold hands and feet

  • Clammy and pale skin

  • Confusion, dizziness or disorientation

  • Shortness of breath

  • Extreme pain or discomfort

  • Nausea and vomiting.

Paediatric Early Warning Sign Score

Elements of the scheme – which monitors children’s vital signs, including heart rate, respiratory rate, blood pressure, oxygen saturation and temperature – have been tested at specialist institutions including Great Ormond Street Hospital.

A uniform Paediatric Early Warning Sign Score (PEWS) system for children in England would mirror the National Early Warning Score for adults being rolled out since last year.

Fiona Smith, professional lead for children and young people at the RCN said: “Nurses have been calling for a national standardised PEWS system for children for over 10 years now. Progress on delivering this has been too slow.”