Parents Want to Shine Light on Pediatric Sepsis

At age 6, Evelyn Bauer was full of light. The youngest of three children, she loved princess stickers, playing school, writing her name and laughing with her siblings.

“Evelyn found joy all the time,” says her mom, Beth. “Nothing could really stop this child.”

Last January, Evelyn came home from kindergarten with a runny nose and spent the next two days at home with what seemed like a cold. When her fever spiked overnight, her parents checked in with her pediatrician, who recommended pain relievers to get the fever under control. Although she preferred being at school, Evelyn enjoyed her afternoons playing with Legos and her Barbie dolls.

“We had been through sickness with our kids before. We didn’t notice any red flags,” recalls Evelyn’s dad, Matt. “She continued to eat and drink and overall acted normally.”

Sudden Changes

The next morning, Evelyn woke up breathing rapidly and was agitated and lethargic. Sensing something was wrong, Beth and Matt drove Evelyn to the local emergency department. Her health was deteriorating rapidly.

“Evelyn walked into the hospital on her own, but she had difficulty standing by herself by the time she was evaluated. Initial tests showed that her blood pressure was dangerously low and her heart rate high,” Matt explains.

Within a few hours and despite interventions, ED physicians told the Bauers that Evelyn needed to be transferred to UH Rainbow Babies & Children’s Hospital. Her condition was critical.

“The paramedics were absolutely phenomenal. They were efficient, caring, and kept me calm,” says Beth. Riding with Evelyn in the ambulance, she learned that her daughter was in septic shock.

Understanding Pediatric Sepsis

Typically, the body’s immune system is able to fight off infections, especially with the help of antibiotics if the infection is caused by bacteria. But in rare cases, and for unknown reasons, it has an exaggerated inflammatory response to infection. Called sepsis, this reaction can prevent organs from working normally. Septic shock occurs when inflammation affects the heart and blood vessels, reducing blood supply to the rest of the body.

“There is no test for sepsis. The condition usually develops and progresses quickly, even within a few hours,” explains Steven Shein, MD, FCCM, Chief of Pediatric Critical Care Medicine at UH Rainbow Babies & Children’s. “Pediatric sepsis can be life-threatening, although approximately 80 to 90 percent of children with the most severe forms that we see in the Intensive Care Unit survive. It’s vital to watch for symptoms and seek emergency treatment as quickly as possible.”

Recognizing Symptoms

Sepsis always occurs in response to an infection—from severe pneumonia to a simple cut. Symptoms preceding sepsis may include fever but signs of the inflammatory condition itself are vague. They include:

• Changes in mental status, such as delirium or confusion
• Severe lethargy
• Inability to eat or drink effectively

“If your child is not responsive or connecting with you, if you feel they are not themselves, talk to your doctor. Communication is key,” says Charles Macias, MD, MPH, Chief Quality Officer for Pediatrics and Chief of Pediatric Emergency Medicine at UH Rainbow Babies & Children’s.

Highest Level of Care

UH Rainbow Babies & Children’s is a national leader in pediatric sepsis, building and refining protocols proven to provide the best quality of care for the condition.

“Pediatric sepsis is the greatest cause of child mortality globally—more far-reaching than pediatric cancer,” says Dr. Macias. “It is our mission to help hospitals across the nation prepare for pediatric sepsis with the knowledge, equipment and processes in place to effectively identify and treat the condition.”

Clearly, Evelyn was in the right place. Upon arrival, she was already in critical condition and had experienced extensive damage to her vital organs. Evelyn received IV antibiotics and fluids, blood pressure medication and cooling tubes to help preserve her extremities, which were starved of oxygenated blood. She was also put on a ventilator to help her to rest and heal. Unfortunately, her health quickly worsened, prompting physicians to start Evelyn on continuous dialysis as well as extracorporeal membrane oxygenation (ECMO), a machine that temporarily takes over the body’s heart and lung functions.

A Lasting Legacy

A day after her arrival at UH Rainbow Babies & Children’s, Evelyn suffered a stroke. Despite extraordinary efforts, there was nothing else doctors could do. Beth and Matt called their family together to say goodbye to Evelyn. She passed away in their arms.

“Our doctors at UH Rainbow were absolutely amazing and such a great comfort. We know she received the best care possible,” says Beth. “Our hope is that Evelyn’s story will help others and raise awareness of this horrible condition. It is the best way we can parent her now.”