Many years ago I worked in paediatrics at the West Middlesex Hospital in London. It really is a long while ago but I remember as if it were yesterday one of the first patients I met doing that job. I will call him Josh. He was just three years old and had been playing at toddler group twelve hours previously. He had a cold but nothing significant enough to stop his Mum from going to work as usual and nothing significant enough to warrant the nursery calling her to take him home. That was the morning. By the time I saw him late that evening he was seriously sick. He looked mottled and lifeless. I admitted him immediately and we worked on him for several hours, but in the early hours of the following morning, I had to have the conversation that every doctor dreads. We had lost our battle and Josh was no longer with us. He died of sepsis.
Sepsis is also known as septicaemia or blood poisoning. It kills 37,000 Britains every year, a thousand of them young children. Another nine thousand children will survive sepsis but some of them with significant disabilities.
I don’t want to scaremonger here. Children under five will get as many as nine colds a year and of course most of them are simple viral illnesses that can be managed at home without the need to even see a GP, let alone require an admission to hospital. So how do we recognise the really sick child? The thing is there is no one sign to look out for but the toddler who is not feeding or is vomiting repeatedly and has had no wet nappies for twelve hours needs assessing. And any child who is ill and feels cold to the touch, has mottled skin or a rash that doesn’t fade when you roll a glass over it, who is breathing very fast or has a fit, or is floppy, lethargic and difficult to rouse, must be seen urgently by a doctor. Sepsis can take over very quickly, within hours, but if we recognise the signs early and act quickly we can beat it.