ED Pathway for Evaluation/Treatment of Infants > 28 Days
of Age and Children with Severe Sepsis
Infants and Children with Severe Sepsis
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Sepsis pathway not indicated: Care/reassessment continues as clinically indicated
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Initiate Pathway
MD/CRNP/RN Rapid Assessment
Assure 1st antibiotic given within 1st hour
Consider need for hydrocortisone
Correct Hypoglycemia, Hypocalcemia
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10 min
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0-20 min
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Rapid NS
20 mL/kg boluses
Repeat as needed
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0-40 min
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60 min
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Fluid Refractory Shock
Titrate Dopamine up to
10 mcg/kg/min
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Consider Observation
in ICU
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Epinephrine infusion
Norepinephrine infusion
Consider Hydrocortisone
for Catecholamine Resistant Shock
RAPID TRANSFER TO PICU WITHIN 1 HOUR
Notify PICU
Tier 1 or 2 as needed
Posted: July 2011
Revised: June 2015
Authors: F. Balamuth, MD; M.K. Funari, RN; J. Lavelle, MD; C. Jacobstein, MD; D. Davis, MD; J. Fitzgerald, MD J. Gerber, MD; T. Metjian, Pharm D; S. Fesnak, MD; L. Hutchins, CRNP; D. Potts, RN