1. Introduction of sepsis 6 at RMCH

2. 4yr male
4/7hx fever
2/7 rash
Lethargy
Grunting

3. Sepsis 6

6. Step 3: Give antibiotics
Ensure that not only is it prescribed but you ensure that it is given. Studies show this is often not given within the hour of recommendation and in a shocked child with low blood pressure, every hour’s delay increases mortality by around 7.6%.

7. Senior nurses
Educators
Sepsis champions
Induction
Guidelines
Intranet

10. PED MTS triage (Manchester triage system) False triggers
Time of review
Not triage failure
Failure of re-assessment
Bristol experience

11. Triggers in PED and outcome

12. PED experience with triggers
Sensitive trigger noticed in PED
Most children are sent home
Need for repeat assessment to clarify trigger
Bristol children’s have a modified system
We will introduce a system where all triggers are reviewed in 30 minutes to validate
Senior review if any concern prior to this.
Still exploring appropriate actions

13. Bristol childrens hospital

14. Bristol children’s hospital

15. Conclusion Good cognitive tool
Good reception by nursing staff and juniors on wards
Directs treatment in a timely fashion
Some concern about increased sensitivity particularly in PED – addressed with review in 30 minutes if no immediate concern.
Integration with electronic warning system is planned.