Paediatric SIRS, Sepsis, and Septic Shock Criteria
Age-adjusted criteria for SIRS, sepsis, severe sepsis, and septic shock in children. Based on International Pediatric Sepsis Consensus Conference (IPSCC) 2005 definitions.
Score interpretation
Insufficient criteria for SIRS -- reassess frequently
→ Monitor closely; serial observations; reassess for evolving sepsis; paediatric sepsis is dynamic -- repeat assessment in 1-2 hours; low threshold for reassessment in infants (< 3 months); document observations; senior review if clinical concern persists despite normal scoring.
SIRS criteria met with or without confirmed infection source
→ Initiate paediatric sepsis pathway (Sepsis 6 adapted for children); urgent bloods: FBC, CRP, PCT, blood cultures x2, lactate, U+E, LFTs, coag, blood gas; IV access (or IO if cannot gain IV within 2 attempts or < 90 seconds); IV/IO fluid bolus: 10-20 mL/kg 0.9% saline or Hartmann's over 5-15 minutes (repeat up to 40-60 mL/kg total, reassessing after each bolus); empirical antibiotics within 1 hour: ceftriaxone 50-80 mg/kg IV (max 2 g) or as per local policy; glucose -- avoid hypoglycaemia; notify paediatric senior within 30 minutes.
Sepsis with organ dysfunction or haemodynamic compromise -- critical emergency
→ Immediate resuscitation team/PICU call; airway -- consider early intubation if tiring or GCS falling; fluid resuscitation: 10-20 mL/kg boluses, reassess after each, up to 40 mL/kg total -- stop if signs of fluid overload (new crackles, hepatomegaly, SpO2 falling); vasopressors if fluid-unresponsive: dopamine 5-20 mcg/kg/min or noradrenaline 0.1-2 mcg/kg/min (both via central or IO access); broad-spectrum antibiotics within 1 hour; glucose monitoring every 30 minutes; hydrocortisone 2 mg/kg IV (max 100 mg) if catecholamine-resistant; blood product support if coagulopathy; contact regional PICU transport team; document PELOD or pSOFA scores; family communication.
Interpretation bands for the Paediatric Sepsis Criteria. Apply clinical judgement and local guidance.
References
- Goldstein B et al. International pediatric sepsis consensus conference: definitions for sepsis and organ dysfunction in pediatrics. Pediatr Crit Care Med. 2005;6(1):2-8.
- NICE NG51. Sepsis: recognition, diagnosis and early management. NICE. 2016 (updated 2021).
Related
Curated clinical cross-links plus same-class fallbacks.
- Gentamicin (Paediatric) · Aminoglycoside — Neonatal Sepsis / Gram-Negative Infections in Children
- Hydrocortisone (ICU — Stress Dosing) · Corticosteroid (ICU/Septic Shock)
- Ibuprofen (Paediatric) · NSAID / Analgesic / Antipyretic
- Paracetamol (Paediatric) · Analgesic / Antipyretic — First-Line Pain and Fever in Children
- Morphine (Paediatric) · Opioid Analgesic — Moderate to Severe Pain in Children
- Ceftriaxone (Paediatric) · Third-Generation Cephalosporin — Meningitis / Sepsis / Community-Acquired Pneumonia
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.