Evaluation for Sepsis - Infant

Your baby is being seen at Nationwide Children’s Hospital to be evaluated for sepsis (SEP sis). Sepsis is a serious condition caused by the body’s reaction to infection. Your baby is here because of one of the following:

• A fever greater than 100.4 degrees F
• A temperature that was too low (“hypothermia”)
• Change in behavior, or
• Change in eating that is worrisome to your baby’s doctors.

Tests That Will Be Done

This evaluation is standard across the country for babies with these symptoms. It is very important that we complete each step as quickly as possible. The tests that we will do are in these areas:

• Blood
  • We will put in an intravenous line (IV) - a small, thin tube inserted into a vein.
  • We will draw blood from the IV to look for infection.
  • We will use the IV to give antibiotics.
• Urine
  • We briefly insert a tiny tube in the urethra (the hole where urine, or pee, comes out) to collect sterile urine from the baby’s bladder.
  • Your baby’s nurse will use a dark brown liquid soap called iodine to clean the area before inserting the tube. The soap sometimes makes the urine look dark.
  • This lets us check for a urinary tract infection (UTI).
• Cerebral spinal fluid (CSF)
  • We will do a test called lumbar puncture, also known as a spinal tap, to collect a small amount of the fluid around the brain and spinal cord.
  • We do this to check for meningitis, an infection around the brain.
• Swabs
  • These are usually done once your baby is admitted to the hospital.
  • We will swab your baby’s nose to look for infection.
  • We will also swab your baby’s skin, eyelid, and bottom to look for infection.

It is important to know that we send cultures from blood, urine and CSF to the lab. There, technicians will look for bacteria that cause serious infections in babies.

About the Lumbar Puncture (LP)

An LP involves inserting a small needle in between the bones in the back. It is similar to an epidural that moms get during labor except instead of putting in numbing medicine, we take out a small amount of fluid.

Most babies tolerate this procedure well and some even sleep through it. We will use numbing cream and give some sugar water on a pacifier to keep your baby comfortable.

The procedure is done in a way that avoids the nerves in the spine. The most common side effect after an LP is a headache. This may mean your baby could be a little fussy. The headache usually stops within one to two hours. As with any procedure there is a very small risk of bleeding or infection. However, we do this procedure under sterile (totally clean) conditions using a very small needle to minimize these risks.

If you have more questions, please ask your baby’s doctor.

Treatment for Fevers

Since it can be hard to tell which babies have a mild virus and which ones have a serious infection, we start by treating all babies as if they have a serious infection. This means starting antibiotics after collecting the blood, urine, and spinal fluids, but before all the test results come back.

If we did not start antibiotics quickly and your baby had a serious infection, it could cause serious, long-lasting problems or even death.

Your baby’s doctor may also give your baby acetaminophen (Tylenol®) to treat a fever.

Your Baby’s Hospital Stay

Your baby will be in the emergency department while we get samples of their blood, urine and spinal fluids to send to the lab for testing and start the first dose of antibiotics through the IV. They will then be admitted to the hospital to continue treatment.

Most young babies like yours stay in the hospital for about 36 to 48 hours while we wait for all the test results to come back. The length of your baby’s stay could vary based on these results and could be longer if we do find a serious infection. Your baby’s medical team is going to work quickly and safely to start the antibiotics and get all of the lab results. We will give the best treatment possible to keep your baby safe and healthy.

The doctor will be in to ask about your baby and to talk about the procedures. Please ask the doctor or nurse any questions you need to have answered.

Follow-Up

It will be very important for you to make an appointment to follow up with your baby’s doctor after you leave the hospital. Call the doctor's office during regular business hours to schedule the follow-up visit.

Evaluation for Sepsis - Infant

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