The excess burden of severe sepsis in Indigenous Australian children: can anything be done?

Schlapbach, Luregn J.; Ostrowski, Justyna A; MacLaren, Graeme

doi:10.5694/mja17.00464

Cited by 1 publication

(1 citation statement)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Root cause analyses after fatal sepsis outcomes in children often report on recurrent presentations to hospital (16) and anecdotal data reveals parents in such cases often indicated concerns that “this disease is different” suggesting parents may have sensed the potential severity of the disease prior to the recognition of sepsis by clinicians. Increasing parental education has been demonstrated to reduce infant mortality due to infections in low income settings (28, 29). Yet the potential value of including parental assessment in discriminating children with mild infections from sepsis has received little attention.…”

Section: Introductionmentioning

confidence: 99%

The Role of Parental Concerns in the Recognition of Sepsis in Children: A Literature Review

2019

View full text Add to dashboard Cite

Background: Sepsis is a time critical disease and outcomes strongly depend on time to initiation of appropriate treatment in hospital. A range of studies have assessed sepsis recognition in hospital settings, whereas little is known about sepsis recognition in the community. The decision-making of parents in seeking medical care may substantially impact survival of children with sepsis. An improved understanding of the parental perspective in recognizing sepsis is urgently needed to inform the design of education campaigns and consideration of using parental concerns as a trigger in sepsis screening tools. Aim: To review the literature on parental concerns in the diagnosis of sepsis in children. Methods: A literature review on parental concerns in pediatric sepsis was performed accessing publications in PubMed, CINAHL and Medline published between 1990 and 2018. In addition, we compared guidelines and online institutional sepsis recognition tools and assessed whether parental concerns were used for screening. Results: Out of 188 articles reviewed, 11 met the criteria. One article was found prospectively assessing the diagnostic performance of parental concern in children evaluated for infection, indicating high positive (16.4) and negative likelihood ratio (0.23) for sepsis/meningitis in presence of parental concerns. The role of parental concern was listed as a sign assisting recognition of sepsis in four studies reporting original data, and six reviews commented on parental concern listed as a factor upon diagnosis of sepsis. When comparing selected examples of institutional sepsis pathways available online, parental concern was variably listed as a criterion to prompt evaluation for sepsis. Conclusions: Despite some guidelines emphasizing the role of parental concern in recognizing sepsis, there is a paucity of data in the field. An improved understanding of whether parental concerns adds diagnostic value to sepsis recognition at acceptable sensitivity and specificity is urgently needed. Future prospective studies should assess whether including parental concerns in sepsis screening tools benefits the assessment resulting in early diagnosis and treatment of children with sepsis.

show abstract

Section: Introductionmentioning

confidence: 99%