Spotting the unwell child – signs of sepsis

What is sepsis?

Sepsis is an emergency medical condition where the immune system overreacts to an infection. It affects people of all ages and, without urgent treatment, can lead to organ failure and death. The numbers are staggering – 245,000 people develop sepsis every year in the UK, and 48,000 die. That’s 120 lives lost to sepsis every single day!

But, crucially, sepsis is often treatable if caught quickly, so it’s really important to be ‘sepsis savvy’ and to just ask: ‘Could it be sepsis?’

Whilst the majority survive, 25,000 children are admitted to hospital with sepsis every year in the UK.

This information will help you monitor your child’s condition so you know:

• When to ask for help
• Where to go
• How to describe the symptoms

Amber symptoms

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 and tongue

Unusually pale skin
Dry mouth, lips and / or tongue

Eating and 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 or nappies

More than five watery poos (diarrhoea) in the last 24 hours in babies younger than 1 year of age
Only 1 wee or wet nappy in 8 hours

Activity and 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

It’s sometimes hard to be sure about particular signs and symptoms. If you feel that your child may be seriously ill, or if something that concerns you is not on these lists, call NHS 111, contact your GP, or go to your local Walk-in Centre depending on your level of concern.

Red symptoms

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 and 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 and 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 or nappies
Not had a wee or wet nappy for 12 hours

Activity and 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

If your child has

Amber symptoms

Seek medical advice and just ask: “Could it be sepsis?”

Red symptoms

Get your child to hospital quickly.

Dial 999 for an ambulance if necessary.

The Sepsis Trust

If you’ve been affected by sepsis, visit sepsistrust.org/get-support, or call 0808 800 0029 to speak to our specialist support team with many years’ experience.

They’re passionate and dedicated to help those struggling with grief, having problems with recovery or trying to support a loved one.

Why doesn’t everyone know about this?

“People often ask me if I’m angry about what happened to Sam. Mostly I feel bereft. What does make me angry is when I hear of the same mistakes that contributed to Sam’s avoidable death happening again and again; more children who die because of delays in diagnosis and treatment; more parents who never had the opportunity to ask “could it be sepsis?” because no one told them it existed.”

Sue Morrish (Sam’s Mum) This information is derived, with permission, from the SAM leaflet produced by NHS England (South West) to improve recognition of sepsis in children. Contributors include paediatricians, sepsis experts, nurses, GPs and parents of children who’ve had sepsis.

All content in this guide, including text and images, belongs to the UK Sepsis Trust.