Background

Sepsis is a life-threatening condition resulting from the body's dysregulated response to infection, leading to tissue damage, organ dysfunction, and potentially death. If not recognized and managed promptly, it may progress to septic shock and multiorgan failure. Adherence to standardized septic shock management protocols has been associated with improved patient outcomes. According to data published in 2020, there were approximately 48.9 million cases of sepsis and 11 million sepsis-related deaths worldwide, accounting for 20% of global mortality. Nearly 20 million cases occurred in children under the age of five. Furthermore, for every 1,000 hospitalized patients, around 15 are estimated to develop sepsis as a complication of healthcare delivery.

Objective

This study aims to evaluate the outcomes of pediatric patients with septic shock who received early protocol-driven management—including fluid resuscitation, inotropic support, and antibiotics—within the first hour of presentation to the emergency department.

Methods

- Design: Retrospective cross sectional study using electronic medical records.

- Setting: Emergency resuscitation rooms supported by Child Life Foundation organization.

- Duration: December 1, 2024 – May 31, 2025.

- Population: Pediatric patients aged 28 days to 13 years, triaged as category P1 or P2, diagnosed with sepsis, severe sepsis, or septic shock.

- Intervention: Administration of intravenous fluid boluses, inotropic support (dopamine, adrenaline), and intravenous antibiotics, in accordance with the standardized septic shock protocol.

Results

A total  of  1704 patients   were included   with   301 patients ( 17.6%) adherence to   septic shock  protocol  and  1403   patients  82.33%  non adherence to  protocol  .Mortality  in  adherence  group  146 (18.5% ) and in   non adherence 926 ( 56% ). 

Conclusion   

Strict adherence to   septic   shock    protocol   significantly   improves   patients outcome  ,  including   reduced   mortality  .Implementing  and maintaining adherence  to these  protocols   should  be  priority  in  Emergency  settings

 

References

1. Dellinger RP, Levy MM, Rhodes A, et al. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Med. 2013;39(2):165-228.

2. Rudd KE, Johnson SC, Agesa KM, et al. Global, regional, and national sepsis incidence and mortality, 1990-2017: analysis for the Global Burden of Disease Study. Lancet. 2020;395(10219):200-211.

3. Weiss SL, Peters MJ, Alhazzani W, et al. Surviving Sepsis Campaign International Guidelines for the Management of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatr Crit Care Med. 2020;21(2):e52-e106.

4. Levy MM, Evans LE, Rhodes A. The Surviving Sepsis Campaign Bundle: 2018 update. Crit Care Med. 2018;46(6):997-1000.

5. Davis AL, Carcillo JA, Aneja RK, et al. American College of Critical Care Medicine Clinical Practice Parameters for Hemodynamic Support of Pediatric and Neonatal Septic Shock. Crit Care Med. 2017;45(6):1061-1093.