Part 2 of our 3 part series on Sepsis in babies and children.
CPR Kids and Children’s Health Queensland have teamed up to bring you a 3 part series on Sepsis in Babies and Children.
In part 2, Paediatric Sepsis Clinical Nurse Consultant (Children’s Health Queensland) Amanda Harley, and Founder of CPR Kids, Paediatric Nurse Sarah Hunstead, will answer the questions many parents have about Sepsis:
– What do I need to know about Sepsis?
– How can I identify the signs and symptoms?
– What are the risk factors for Sepsis?
– What do I do if I suspect my little one has Sepsis?
– How can I prevent Sepsis?


Hello everyone And welcome today we are talking A part two of our three-part series on Sepsis in babies and children My name is sarah hunstad i am a Pediatric nurse Mum of two gorgeous girls well Occasionally gorgeous they can be rap Bags as well sometimes but anyway that's Another story Um and i'm also founder of cpr kids And today i am joined by amanda harley Who is and i'm going to read off your Title off my notes here amanda because i Don't want to get it wrong Because it is a rather fabulous title You are the pediatric sepsis clinical Nurse consultant for children's health Queensland have i got that right Pretty 99 right i'll take it oh okay Good okay all right that's not too bad That's not too bad But before i get you to tell us a bit About yourself Um i'm just gonna let everybody know What we're going to be talking about Today and while i'm doing that Guys if you can give us a thumbs up or a Wave Just so that i know that all the Technology is working well Because um a couple of facebook lives Ago i forgot to turn Off mute on my microphone and not only

Was that really rather silly Uh but i forgot to look at the comments And didn't realize that it was on mute Until it was about seven minutes in So we're not going to do that today Thumbs up or whatever you'd like To say hi tell us where you are just in The comments but we're going to be Talking about Basically what sepsis is so your Role as a parent or carer family member In identifying you know the signs and Symptoms and What role you have in that and certainly What the risk factors are And recognition and prevention as well And we've also got a fabulous website From children's health queensland that i Want to show you afterwards as well And we're going to put some resources in The comments too So please make sure that you tag anybody In the comments below who you think will Benefit From this life-saving information so I've chatted enough now Amanda tell us a bit about yourself how Long do we have We have quite a while we have a while All the information on this let's be Honest So my first disclaimer is that i am Historically an emergency department Nurse

So i'm one of those people that may look A little bit grumpy at 4am when you come In To the emergency department but i want To be very clear that we Are always there to help and the role And the information you tell us is Really really important And when we care for your child so That's my first disclaimer Now with the emergency department Background i'm inherently A fixer so what i like to do is i like To fix things i like to solve problems Yet to find sometimes i can't solve all Problems but i like to Try most certainly so with the role that I'm in at the moment and that Is essentially i think why i am so Interested in pediatric sepsis and why I'm so passionate about it Is because pediatric sepsis is such a Complex condition But what we're learning is that it it Really is a role that everyone plays a Part in and i'm really blessed and feel Very privileged to come and speak to you Guys all here today And talk to you about the role that you Can really play um in pediatric sepsis Recognition and escalation to um health Services I'm that interested in pediatric sets is That i also decided i would do a phd in

It Because i've got a lot of spare time and I thought you know what Why not go one step further and uh read Some more textbooks in my spare time Yeah but not to without failing the fun Part As well is that if you're ever on the Gold coast i am a body pump instructor So if you feel like you'd like a bit of Exercise after all this information You can just fly on up to the gold coast That's the uh fun fact here I just have visions of you with reading Literature with one hand and just like Giving it one of these ones with the Other Like honestly i can see it i can see it Happening have you been in my house Because that's what it sounded like That's awesome i knew i knew a year Absolute package i've been thinking About Just hearing you say you're an emergency Nurse i'm an emergency nurse too So um and the other thing as well Everybody who's watching emergency Nurses like to over share a little bit So You've been warned okay at the beginning Yeah we're here all right so Let's get into what we really need to Talk about today and that is What is sepsis so um can you explain

To all of us who are watching it just What is it and How is it relevant when we're parents or Families when we're looking after little Kids Yeah absolutely so i think first up some Of the things we might discuss Might seem really really scary because Sepsis is a scary condition But again the good thing about sepsis is If we recognize it early We can really put a stop in those really Adverse outcomes we may see for children That have sepsis The big thing that i really want you to Think about is that you can't have Sepsis without an Infection so your child might have a Chest infection they might have a Urinary infection that might just be an Infection that you know you have You treat it you have some antibiotics And it goes away But sepsis is something that happens um When a child has an infection And it and it causes the body to go into This haywire response And in turn it starts to damage its own Organs We don't know why we don't know why some More than others but it's an infection That then turns into this overwhelming Response that can be quite dangerous and Deadly

Right can i just say that is one of the Clearest definitions of sepsis i've ever Heard Like just being able to understand that You know that it is having an infection And then Hearing that it's this body's haywire Response to it I think that just will really clarify That for so many people out there so Thank you for um Actually you know saying such a clear Succinct understanding what sepsis Is um so now that we understand exactly What it is I guess one of the main questions Certainly that we Get asked in our pediatric um first aid Classes and so on when we do go on to Things like you know if we get asked Questions about fever and infection and So on is You know what are the signs and symptoms What are as parents and families are we Actually looking out for In our kids when they're sick yeah So i think again the first thing to keep In mind is because it can happen from Any infection so let's say it could be a Bacterial it could be a viral it could Be a fungal who knows it happens all Around the world so depending on where You live There's obviously different pathogens

Around the place So because let's use a chest infection Because that's quite common in young Children isn't that You might have a chest infection so Already they have a runny nose A cough maybe it's a dry cough maybe It's a wet cough Maybe they're sleeping a lot because They're unwell those all could be normal Symptoms as part of that infection okay But what what we need to know really Then is when something changes The difficulty with sepsis is all of Those symptoms i've just said Could actually be signs of sepsis or They could be the chest infection So how do you know what the difference Sort of is That's where it's tricky yep um i think What the big thing is Is one when it changes your child may Have been unwell For several days they're not really Getting any better or maybe they got a Little bit better but now they're Getting worse again That a change in the condition so They've had the same illness they've had The same infection but now something has Changed And the big red flags we think about are Um you know irritability so excessive Irritability so

Yes they're grumpy because they've got They're unwell they've got a fever But it's just something to keep an eye On and i think the big thing is if you Think about i like to think about Sepsis as a puzzle so you've got all These little puzzle pieces that you're Literally putting together To then say oh hold on i think this Actually could be sepsis Okay so um you know rattling some of Them off irritability Um excessive sleeping maybe it's little Things like um they're not eating and Drinking as much as normal Decreased wet nappies things like that Um They're not acting their normal self and Depending on how old your child is Obviously they'll manifest a little bit Differently so a really young baby They might not be sucking as well when They're feeding as normal And that one sign in itself we can't say Yes that's definitely sepsis It may be a combination of those things And then the really obvious things Are things that we're really concerned About are like rashes That when you press on them with a glass They don't disappear When you physically can't wake your Child at all obviously that's Very very um big red flag but then also

Things like Shortness of breath um you can see their Their stomach moving in it moving in and Out And they're breathing really really Quickly or they're breathing really Slowly Um you might hold them and you can feel Their heart rate going fast and fast and Fast Things like that again things that we're We're a little bit cautious of And we'd really like to see those Children to be able to start to Hopefully put those puzzle pieces Together Yep absolutely you know i find it really Interesting what you're saying about That puzzle analogy Because a friend of mine when she had Her First child she put she was only i think Eight weeks old she put her down To sleep noticed that normally she she Was one of those kids who Just went to sleep from a very early age It was just her She cried every time that her mum laid Her down She tried feeding her but she wasn't Feeling properly She noticed that she was breathing more Rapidly than usual And she just went this isn't right i

Actually don't know what's wrong with my Baby But this just isn't right and she took Her up to the hospital And she ended up having sepsis and she Was hospitalized and Obviously hospital did everything that They did and you know she's a teenager Now so you know She did all right but what really stands Out to me there Is the fact that she didn't know the Diagnosis she didn't know a child had Sexes But she knew that what she was doing was Different to normal and she trusted her Gut and went And got help and i think that those Puzzle pieces um Are a great analogy a great way to Saying that So um one thing that i am curious about Is that what are the risk factors i mean You talked about age there as well uh Younger children More at risk than older children or are There other risk factors what what What yeah that's not true yeah what are They i knew what you were saying what Are they Good so i think the first again um There's some children and adults as well That get sepsis And we have no idea why so we can't

Quite figure it out we think that there Is some sort of Genetic anomaly that occurs within the Body Um but that's the first disclaimer so Sometimes Children get sepsis we'll never know why There are though if you think about it's An infection the body Body is responding that do put you more Risk than others so for example children That are immunocompromised for some Reason children that Perhaps you might have a child that gets Sick again And again and again and again and They're prone to infection so Obviously the more infections you get The more chance you have of getting Sepsis But also more importantly to that is Children that may be on Um chemotherapy they may be treating for Cancer they might be um Treating for maybe um some sort of like Crohn's Autoimmune disease that they're having To take medication to suppress that Immune system They're less able to fight off an Infection so they're at risk Aboriginal and torres strait islander Children are also at higher risk as well Little tiny babies so babies under three

Months old Also again it makes sense their immune System is not as equipped As an older child but then for the Proportion of children that do have Sepsis Um it's in the less than five age group Um that we see it a little bit more And that's just that's also Internationally as well as in australia Um and you think about it is again we Don't know why but they're a really Tricky age group because they can't Articulate And tell you hey mum i really feel Rubbish or i actually feel worse Now whereas older children and adults Have been you know historically Documented to say I feel really sick something is not Right i just feel like i'm going to die A three-year-old is not going to be able To tell you that and that's where we See the difference in what actually Sepsis is but I think as well i might just add those Are the risk factors and As well surgeries maybe you've had a Surgery so again you're at more risk of An infection There maybe um you've got a device in Something like that But i think as well really important and I want you guys to know that

We say it all the time parents are the Expert of their child but what does that Actually mean but what it means is you Are Essentially the walking textbook that Accompanies that child So things that we as a health Professional won't know about your child You absolutely will So when you're sharing that information With health services you might say look This is going to sound strange but my Child is actually sleeping more They just woke up from their sleep they Had a feed for You know they had a little bit of food Or they had to feed and then they've Gone straight back to sleep and they're Just really drowsy We might say well children do sleep a Lot at this age and you say yep but my Child doesn't This is definitely different and this Illness is different they've had lots of Chest infections before but Something's not right and that clinical Intuition that we feel And and we feel it every day in life in Our own lives you might think I've really got to go to the gym but Your body's telling you No you don't go to the gym you've got a Jam-packed day it's going to you're Going to end in a tears

You get to the other day you've you've Slotted the gym session in and then You're a blithering mess because you've Just overwhelmed Yourself and you've done way too much You should have listened to your gut Instinct Yeah you're exactly right then um but It's not an excuse Either so that's that's the thing you Should listen to your gut but i might Like my brain might like to tell myself That even when my gut isn't telling Myself that but that's another Talk about that later yeah yeah we will We will we will there's a difference Between gut and motivation but that's Okay Um but i think what you're saying there Is one of the biggest things i'm curious If the people who are watching at the Moment Do you actually do you trust your gut When it comes to your children would you Have the confidence that If you have presented to say an Emergency department or your gp And they're saying you know to you oh But this is normal for kids would you Actually say Yes but this is not normal for my child I'm i'm really curious as to that so Please if you're watching now while We're live please comment down below

Because i'd Love to know um if you do have that Confidence to do that So yeah just curious now Um can we keep going with this um with This trust your gut and also confidence Thing because I think this is so important now i Suspect I'm significantly older than you um i Started nursing Quite a while ago but that's okay um and Certainly i'm actually 17. this job's Made me look like this Well i'm only 24. so this is what Yeah yeah this is what night judy does To you after a very long time But that's all right i loved i loved Night judy i'd never do it again Anyway i digress again now so what was i Saying I've lost my train of thought now gut Instinct and intuition Intuition thank you thank you very much Okay so just say okay Your child's unwell you've presented to Ed Okay you've been there a while they've Been observing your child for example or Perhaps you've been Sent home and you know because uh you've Had You know had some kind of diagnosis but Then your child starts to get worse

So you know or if you're in hospital and You notice your child just they're not Getting better we i know we expect Kids to get better but they're not Things are getting worse What can we do well you know what should We do as parents Um definitely speak up so i think Definitely speak up to the Nurse or doctor or gp wherever you are And speak up because i think what Happens is Um we're now treating a chest infection But the clinician might think that we we Too have gut instincts right and it's Based on previous experience you can't Put your finger on it same as a parent You can't put your finger On it but again something's not right so I might assess the child This is what we're treating for um we're Going to just give them a little bit of Fluid and we're going to keep an eye on Them Now the trap we fall into is thinking Well we're out of the woods that's it We're all good we're having some fluid We're monitoring and that's okay and We'll go Home but the nature of sepsis and again If you think about Um an hourglass timer is things move Very slowly in the beginning Sometimes and it's all very non-specific

And then suddenly the sand stand drops And you have this rapid deterioration so You may well be Observing your child and something again Subtly Even in a hospital might change now it's Not that the doctors and nurses miss Something It's just this illness pattern was Recognized as a chest infection But now we're actually looking at Something different and that's something Different Is sepsis and those little signs that Are coming out and making it glaringly Obvious If you don't speak up obviously you know The nurses or doctors might not come Back for a few hours because they're Everything is on track but if you speak Up and just even if it seems like Something really small They can at least come and assess and Say okay Yes actually you're right this is Actually now something we're worried About and Look at the child's heart rate it's Actually gone up so Signs and symptoms from medical Perspective may complement what you're Seeing as a parent which is your child's Really irritable right now And they they don't even want to be held

For them again that's not normal So that's that gut feeling you don't Have to know the medical stuff you don't Need to know You just need to know that sepsis does Happen with any infection And that we absolutely want to hear from You as a parent um don't feel like You're bothering us We're there to help your child and you And get on the road to recovery And you really are key to that it's a Team effort And we really really value your input Because you know your child best Yep absolutely that is so true and That's where i was going with the being An old nurse thing Was that even you know that long time Ago when I was learning nursing we always taught To listen to the parents and to trust Our gut and i think that is something That more and more And more that you know clinicians are Really understanding is that it's a team We are a team to look with you To look after your child and that is so So Important now what about prevention So we've talked about how to recognize Sepsis with the signs and symptoms we've Talked about the risk factors Um we've talked about what to do if

You're worried about your child that They're becoming worse But um can we prevent sepsis at all So you can prevent it in the way that You would um prevent an infection Really because again you can't have Sepsis without an infection so whatever Infection that is That's the biggest thing so in Preventing the infection so Things like obviously um hand hygiene so You know washing our hands before we're Eating um all those basic Things um if your child's got a wound Because this this is one that really Stumps people you can get sepsis from a Graze on the knee So your child perhaps however old they Are out maybe learning to ride a bike They fall off they graze their knee um They've got gravel in it It starts to look a little bit maybe not Great in a couple of days it's looking a Bit ripe If we don't keep on top of that cleaning And even so That is an entry point for bacteria and That can also cause sepsis so there has Been children that have had sepsis from Grazers it's as simple as that and so Keeping up good wound care obviously Vaccinations Um we've seen and you know an Eradication of a lot of infections and

And really quite dangerous Um pathogens since the introduction of Immunizations and vaccinations So those things that you know covering Mouths when coughing Um all those things that we've learned And covert 19 has taught us a lot about Those things so Our handwriting's definitely improved Since that That's for sure but i think you're um The prevention is also this is a little Bit out there But your prevention is also in you guys Spreading the word So not going around terrifying everyone But just saying Have you heard of sepsis um you don't Need to know much about it you just need To know You know the basics and then when to Seek help and if you're ever unsure About what you're looking at Going something's not right i remember Some crazy lady talking about sexist I'm going to go to a medical Professional um Knowledge and awareness is really power In in beating this this disease and the More we know that the more we speak About it The more we actually um spread the word And and And normalize having conversations about

It people have heard about it and then They can go and say oh Excuse me doctor um actually these are The things i'm worried about and you're Giving a clear story The doctor can go okay yeah that that Actually does sound concerning Um let's look into this um and again They're your ally Yep absolutely and i think that that's Incredibly important Um you know and in saying that what While we're talking to you about this Today it can sound Incredibly frightening and i think some People may want to stick their kids in a Little Plastic bag with holes in it so they can Breathe um So that they don't get anything around Them but it's it's not about that it's Not about that it's The key to this is if you are feeling Frightened about what we're talking About turn it around you're armed with Knowledge You're armed with knowledge to know what To look for and that's confidence So you know that there's signs to look Out for and I think that's one of the most important Things you're simply being armed with Knowledge And of course we need to let our kids

Get out there And climb trees and fall off and graze Their knees and eat dirt and do all that Kind of stuff But it's just about you know being Balancing and washing your hands with Soap and water And cleaning a graze when it's there and So on and that's the important bit And the hardest part of parenting is Balance it's ridiculous So that's one of those things but Remember knowledge is power and it's Really really important So yes keep going okay Think of something else i think as well As as scary as it as it may be it's Really important to also Know though that if you get it early It'll be okay Yeah it'll be okay you know it's getting It earlier it's getting treatment early Um it's not a terminal diagnosis you Know If you get this early and you clued on To the signs and you And you watch your child and just watch For little changes or when something Isn't quite right And it's also okay to get a second Opinion is the other thing If you're not happy with something and You still it doesn't sit right with you It is okay

To go somewhere else it's also okay that Things might change in the matter of Three hours So you might have been sent home from The emergency department you get them Home Now something still doesn't seem right And again something's changed again So you just go back to the emergency Department no one's gonna say oh they Were here three hours ago They haven't listened to our advice We'll actually know these this is why I'm back And this is why i'm concerned um and Again it may be a matter of monitoring Or it may be a matter of actually Treating straight away But again we can't do it without you Guys we can't do without you guys The earlier you come and get care and Help um You know the better outcomes there will Be yeah absolutely And the good thing is is that children's Health queensland have also Well you have actually brought a Pamphlet today That i think summarizes everything Beautifully Because i don't know about you but if When i was well I know that when i had my kids my brain Did not retain anything

So being able to have resources such as The new website is absolutely fantastic Which i will put Their web address and put it in the Comments below for everyone But there's also this resource which i Thought was absolutely fantastic Which was could this be sepsis with Queensland health do you want to step us Through this Yeah so i think again again like we said If you if you know the word and you just Know that That it it's something that happens when You've got an infection That can be quite dangerous you can ask The doctors and nurses this Look i've heard about this sepsis word Could this be sepsis This is what i'm concerned about so Using that language as well But essentially a few things that i Spoke about with the signs and symptoms Are things that really you can use to Come back to a hospital or things that You might be at home and you might have This is available on the website so you Might actually say oh hang on These are signs i'm concerned about Which is you know this irritability um Things like seizures for example um A child might not have had a seizure Before and they've had a seizure that That's concerning and

Requires you to go to the hospital so It's just um an easy access Document that at least will give you a Bit more information And you can also use it to track things And keep an eye on things if If things are changing so you know you May have gone from Four wet nappies a day to one so well That is a change Um even though they they're still Drinking a little bit less but maybe Um that doesn't make sense to you so you Can tick that box And you can have that information and go To the health service and just say This is what we're concerned about um And children that are seen in um Emergency departments up up here in Queensland um this information is given To them on discharge So the doctors and nurses were treating For a simple infection we know children Get infections All the time and nine times out of ten It's completely fine Because where you need that knowledge Yeah so you take this home you keep an Eye on it Um and then you can go back and again You're all speaking the same language These are the things that Are different than six hours ago and the Doctor and i said

Okay that's the information we need um What we're seeing We're still not sure if it's sepsis but Deterio you know Changes in pattern um are happening so Let's let's treat it Fantastic yep great now i'm going to pop That in the comments below as well so Uh and of course just even if even a Quick google About that it will come up it is so Don't worry Make sure you save it as well though i Think that's a really good thing to do Is save it to the files on your phone So it's there just it's such a good Resource to have So i will put that in the comments below Now Jenny has actually said as well what a Fantastic resource jenny i agree with You it absolutely is But in regards to what we were talking About before about trusting a gut and Being able to say something Jenny said that she has been able to say That and i think that's a fantastic Thing I think often we can think oh the Doctors and nurses you know We're handing over our child to them and You know are A bit you know they know what they're Doing they're the experts but you know

What You're the expert in your child you Absolutely are the expert in your child And that Is the most important thing so susie has Also commented So susie has said in the past she would Never have had the confidence to Question a medical professional Now she's learned so much and will stand Up for a child if something is not right Knowledge is definitely empowering and Life-saving That it is well summarized susie Absolutely You are 100 correct so Does anybody have any questions for us If you do now Is the time to pop them down below while We are live if you're watching it as a Recording unfortunately we Won't be able to answer your questions But um If you're watching live now and you'll Know if you're watching live because it Has live Across the screen for you so that's how You will know I need that information that's good for Me yeah so don't worry you'll know if You're watching live because it says so If you're not you're watching the Recording okay so don't ask any Questions we'd love to answer them but

We can't Um because amanda's probably teaching a Body pump class so It's not good for our health to do that It is not good for our health yeah we Have to Boundaries with social media that's Really that's also important Okay so i don't looking around we've got Lots and lots of comments which is just Lovely we've got lots of Thank yous and great resources so that Is Really really great to hear i agree i Agree i think it's absolutely brilliant What i'd love to do is just quickly tell Everybody as well that In i think it's in two weeks time i'm Not going to tell you the date because i Will get it wrong Um i am actually going to be talking to With part Three of this series to a Wonderful mum called amy whose daughter Mia Um had sepsis and We're going to talk about her or the Family's journey through that and I've had the privilege of talking to amy Already she is an extraordinary human Being who I you know please come and tune in and Watch Because you'll be captivated by her

Every word and I think it's really important that every Single parent and family hears Their story i really do i'm going to Leave it there because I want you to come and watch amanda do You want to say anything about that Because i'm sure you know amy Oh i think again the more we we talk About this and hear about it and and Resonate with different people that have Had these experiences we say oh Okay i completely appreciate where that Person's coming from and again Because it's so sneaky this illness Hearing from someone another mom um is Really really Important because you know you could Save save a life Um get to a hospital early um it's Really really Um good information to share and talking About And normalize it yeah that's right this Is something that we should be talking About it's okay to talk about it and we Should be normalizing Everything that we've talked about today From it comes from care Um to yeah all of that now Why before we actually uh started uh Talking about this today i asked amanda What her key messages were What were the things that amanda wanted

You guys to know the most So do you want to share those now amanda As we wrap up today before we go Okay tell me go for it now there's a lot Of them but i've kept them brief okay So the number one is is really trust Your gut When something doesn't feel right and Don't worry that you don't know all the Medical stuff Don't worry about that your role as the Parent to advocate is that there's that Gut instinct in that clinic And that intuition yeah i think the Second thing is that Onto that is you are a key part of the Team in decision making so Doctors and nurses we really want to Hear from you we really want to hear Your story we really want to hear things That might not seem like much to you but It might be a really Key red flag to us so tell us everything Um we want that information to to you Know to be able to treat child the best Way we think so Um i think the other thing is that You're the expert of your child As we've said um and all really the key For sepsis Is getting it early so getting it early Is it starts in the community So 85 up of sepsis begins At home and comes through the emergency

Department so with that in mind You guys see it earlier you guys see it Way before us So by you being aware of it you're Having a little bit of knowledge On on it hopefully you've learned today Um you're really a key to stopping Sepsis medical medicine can only do so Much With but without you guys we can't do it Absolutely incredible amanda i have Learned so much today i imagine that our Audience has learned an incredible Amount From you not only are you an Expert in your field you are so Personable And articulate it has been an absolute Delight talking with you today And i would love it if you could come Back another time to do this again Because i think the more that we talk About this as you said the more that we Get it out there To be honest it comes down to you know To People being aware and being able to Help save their kids lives and that's What this is all about So thank you so much thank you to Everybody who has tuned in We will see you again very soon and Uh any questions that you do have Remember we've got these resources

Down below make sure you have a look at The website and we'll see you soon Okay bye everyone bye

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