Sepsis checklist for children

The checklist for children is specially designed to meet the needs of newborns and children and provides information on


Risk factors: Special circumstances that increase the risk of sepsis in children. Early warning signs: Signs that indicate possible sepsis.
Emergency signs: Symptoms that require immediate medical attention.


Newborns and children are particularly susceptible to sepsis. This checklist helps parents, caregivers and medical staff to react quickly to possible signs and take appropriate action.

Step 1: Risk factors

Step 2: Amber symptoms

Step 3: Red symptoms

Premature babies, newborns and infants

Children with malnutrition

Children with cancer

Chronically ill children

Children with immune deficiency (congenital or acquired)

Children with reduced circulation (e.g. congenital heart defects)

Chronic bacterial colonization of children with pathological germs (e.g. cystic fibrosis)

Critically ill children

Children with foreign bodies in the body such as bladder catheters, central venous catheters, ventilation tubes, etc.

Disadvantaged social circumstances

Spleen missing

Missing vaccinations

Temperature

Raised temperature (more than 37.5° C for five days or more

Shivering or shaking

Breathing

Nostrils change size with each breath

Breathing that’s noisy or sounds ‘crackly’

Cough that sounds like a seal barking

Skin, Lips & Tongue

Unusually pale skin

Dry mouth, lips and/or tongue

Eating & Drinking

Baby who is not feeding (taking less than half their usual amount of milk)

Eating much less than normal

Has vomited (been sick) more than twice in the last 24 hours

Toilet/Nappies

More than five watery poos (diarrhoea) in the last 24 hours in babies younger than one year of age

Only one wee or wet nappy in eight hours

Activity & Body

Less interested than usual in playing

Difficult to wake up or unusually sleepy

Swelling of a limb or joint

Not using/putting weight on an arm, leg, hand or foot

Temperature

Temperature over 38°C in babies under three months

Temperature over 39°C in babies aged three to six months

Any high temperature in a child who cannot be encouraged to show interest in anything

Low temperature (below 36°C, check three times in a 10 minute period)

Breathing

Finding it much harder to breathe than normal – looks like hard work

Making ‘grunting’ noises with every breath (in newborns this may sound like a lamb bleating)

Very fast breathing (more than one breath each second in babies)

Can’t say more than a few words at once (for older children who normally talk)

Breathing that obviously ‘pauses’

Skin, Lips & Tongue

Skin is blue, mottled (purplish, red) or very pale

Lips or tongue are bluish

Eyes look ‘sunken’

Hands and feet are unusually cold to touch

Rash that does not fade when pressed firmly (use a clear glass)

Eating & Drinking

New baby under one month old with no interest in feeding

Not drinking for more than eight hours (when awake)

Extremely thirsty

Unable to keep fluids down

Persistently vomiting for more than 24 hours

Bile-stained (green), bloody or black vomit/sick

Toilet/Nappies

Not had a wee or wet nappy for 12 hours

Activity & Body

Soft spot on a baby’s head is bulging

Child cannot be encouraged to show interest in anything

Baby is floppy

Weak, ‘whining’ or continuous crying in a younger child

Older child who’s confused

Not responding or very irritable

Hard to wake up, won’t stay awake or doesn’t seem to recognise you

Stiff neck, especially when trying to look up and down

next (Step 2: Amber symptoms)

Possible outcome

Please provide your details first so that we can give you an assessment or recommendation for action.

Our checklists do not claim to be exhaustive and should always be used in combination with a medical assessment. - ©Sepsis Foundation


Learn more about sepsis by visiting our Frequently Asked Questions (FAQ). Click here for more information