I suspect sepsis - have I been fobbed off?

[teamaven]

I called an ambulance for my 5 year old daughter this morning (who is never ill and I’ve never phoned an ambulance so to me it was serious). She woke up at 1:30am screaming and crying that her lower left side hurt. She said she couldn’t move and wouldn’t settle all night despite us thinking she’ll be fine and trying to go back to sleep - then started complaining of a headache at the back of her head and her temp went up to 39.9.

She was extremely hot to the touch, a bit confused and lethargic so I panicked and called an ambulance. After an hour of Neurofen her temp went down to 38.4 and stayed like that for a couple of hours.

I suspected a urine infection (possibly that had developed into sepsis!) because she has had one before and her pull up (she’s still in them at night) was so heavy and absolutely reeked. Her urine test showed signs of infection so the doctor agreed it was probably an infection that had travelled up.

Now, I did ask him to do a blood test anyhow and he said it wouldn’t show anything, but would it not show how bad the infection is ie sepsis? He sent us home with 10 days oral antibiotics and daughter is asleep now but I’m scared that based on her symptoms it was much worse than just a urine infection? The very high temp, lethargy, confusion, headache?

Can anyone provide what the usual pathway is when a child comes in with those symptoms? I feel like we shouldn’t have been sent home - at least to be observed over a few hours?

@ToffeePenniean LP is the only procedure we try and get the parents to go out as it’s so distressing to witness.

Sepsis is not diagnosed just on blood tests. All those you’ve mentioned would just indicate an infection or inflammation

https://sepsistrust.org/

Say this to those who set OSCE exams in UK universities and see them laugh.

My baby was dying, they were doing everything in their power to keep him alive. He had already “died” in the ambulance on the way to hospital and was on oxygen, after rescue breaths from the EMT.
I was so grateful they did what they did. My son survived and is now a healthy(ish) 8 year old who’s looking at a career in the entertainment industry.
I’m so grateful they hustled me out of there asap. Like I said, I still heard the screaming, but the lovely nurse just took me for a cuppa and sat me down and got me to tell her about my boy rather than having to be in there. When I finally got back, his little onesie was coated in blood; all up both his arms and his back. He had restrictors on his arms to stop him from tearing out his cannulas (in both hands) and massive bandages covering his entire chest and one around his foot to stop him yanking off the O2 Sat monitor.
It was just the worst week of my life.

You do not die within 24 hours with sepsis, that's a gross generalisation. Very many people have sepsis for days before they're taken seriously and then continue with sepsis for weeks in and out of hospital. If you go into septic shock then you could die quickly but that could be hours or days.

Always ask if it could be sepsis. Despite posters adorning the walls of what to look out for, they don’t see it until it’s too late. If you think she has sepsis, take her back.

I would also add, trust your instinct over a Mumsnet thread and even a doctor. You have mothers intuition for a reason, it isn’t a myth, it’s very real, trust it above all else.

As a very crude rule of thumb, in kids (not babies) if you get the temperature down and their obs settle and they perk up, it usually is not sepsis. If you get their temp down and their obs are still abnormal and they haven’t perked up, it may well be. So if she’s cooled down and still looks and feels shit it’s worth going back. With regards to bloods, they’re done less routinely in small children than in other groups because it’s a balance between the distress caused and the usefulness. I’ve seen meningococcal sepsis in someone with a normal CRP (thank god my spidey sense was tingling on that one), and non septic kids with a CRP over 200. Lactate and blood gas can sometimes be helpful.

Not true. They ignored my sister twice when she did have sepsis. She survived but was very poorly.

Lots of people with sepsis don’t die. There’s so much misinformation on here!

Agreed!

And the absolutely shameful fearmongering about lumbar punctures, illustrated with gory, and entirely made up, stories.

These medical threads always bring out the excitable ghouls, absolutely the worst of Munsnet. Shame on you all, including @ToffeePennie

We say it every day in hospital and in ICU.

Sepsis isn't diagnosed by one test alone.

Never has been.

You can be ill with an infection.

Sepsis has a very wide continum.

I liken it to a motorway.

Junction 1 mild
Junction 20 severe.

You can be anywhere along the motorway.

But I'll say it again, sepsis isn't diagnosed on one blood test alone.

If you have an infection your inflammatory markers will be up, it doesn't mean you're septic.

Thank you. Because there are 'health professionals' here, saying all sorts of rubbish.

To add on: go with your instinct - ignore the so-called 'health professionals' - because Bawa Garba was one - even a paediatric consultant, my arse, and the patient, now dead, had sepsis.

She wasn’t a consultant. She was a registrar, on her first day back after maternity leave, with no induction, understaffed, with a computer failure meaning no results available for hours. She told the actual consultant about that poor kid, and despite every paediatrician I know agreeing they’d have legged it down the corridor to review him, he couldn’t be fucking bothered to review him. It’s the consultant that should have been prosecuted and struck off, instead of being let flee the country. But he was white.

Not to mention, the parents actually gave the child a medication to lower his BP, when it was already critically low.

But yes let's blame the Registrar, working in horrendous conditions, with every single obstacle being put in her way.

Did the consultant also, before he fled the country, stopped the resuscitation attempts, or was it Bawa?

The only person I feel sorry for is the poor nurse, who was struck off, her career destroyed. You see way-cism, I see classism. BMA sticks up for the precious doctors, but nurses - naaah, they are expendable.

The team leader of a resuscitation can stop it. That can be anyone who is ALS trained.

Once all reversible causes of a cardiac arrest have been explored and treated if the patient still has no cardiac output then it should be called.

Resuscitation attempts rarely work. What was crucial was preventing that deterioration. The consultant clearly should have reviewed him the moment he heard about him, which was before he crashed.

From memory Bawa was thrown to the wolves.
She wasn't supported at all.

Recollections may vary (c).

I AM ASKING if they assessed her