When an everyday accident leads to sepsis – what we can learn from Sadie’s story
Wednesday 12 June 2019
We all expect kids to be a bit accident prone. In fact, getting into a few scrapes as they play is a useful way for children to learn about their bodies and environment. But when Kath’s four-year-old daughter Sadie had a bike accident at the park, she had no idea the resulting sore foot would lead to sepsis, a life-threatening condition that would see her little girl admitted to Queensland Children’s Hospital (QCH) for over a week.
“Sadie had a bike accident at the local park: her foot got stuck in the wheel of a bike,” says Kath. “She got a pretty bad graze on the surface and she was in a lot of pain, so we went up to the hospital. They had a look and they said it looked pretty superficial, they did an x-ray and put a dressing on it for us, and then we went home.”
What causes sepsis?
Sepsis, a deadly condition that occurs when the body responds to an infection and begins to injure its own tissues and organs, can happen in response to all infections. Influenza, streptococcal infections or even, like for Sadie, an infected graze on the foot, can cause sepsis. Sepsis can lead to severe outcomes including limb amputations, cognitive impairment and death, and can progress rapidly in children, with 50% of sepsis related deaths in children occurring within 24 hours.
Two days after her accident, Sadie began to show the first signs of sepsis when she started vomiting out of the blue. Kath took Sadie to their family GP, but neither of them realised yet that this new symptom was related to Sadie’s foot injury.
The symptoms of sepsis can vary from person to person and can often look similar to other conditions like the flu. A child with sepsis might have one or more of the following symptoms:
- convulsions or fits
- rapid breathing
- discoloured or blotchy skin, or skin that is very pale or bluish
- a rash that doesn’t fade when pressed
- a high or very low temperature
- not passing urine (or no wet nappies) for several hours
- not feeding or eating
- sleeping, confused or irritable
- pain or discomfort that doesn’t respond to ordinary pain relief like paracetamol
When Sadie saw her GP after she vomited, Kath says she was bouncing around - obviously a little unwell - but still her normal, cheerful self. By the next day, Sadie’s kindy teachers were calling Kath to ask if they could give her paracetamol because she had a very high temperature and was lethargic. Kath’s mother went to pick Sadie up and, after noticing she was breathing rapidly and was floppy, took her straight to Queensland Children’s Hospital.
Kath says she knew something was seriously wrong with her daughter when she met her mum and Sadie at the hospital.
“It was once we were inside Emergency and they started talking about intravenous therapy – that was when I knew it was pretty serious,” says Kath. “Her doctor showed me her chart, and I could see that a lot of her vital signs, her pulse, her temperature, were really well outside the normal range.”
“She started out with fluid resuscitation and she started IV antibiotics around the same time. Between those two she was kept stable, but it didn’t stop the infection, and 24 hours later she was put on a different antibiotic. It was probably a good 48 hours before it was really under control.”
All-in-all, Sadie spent nine days in QCH, had an operation to clear the infection in her foot, and spent the following two months working with plastic surgeons, occupational therapists and physiotherapists. Now that Sadie’s back to normal, with only a small scar on her foot to show for her ordeal, Kath knows how close their family came to much more severe outcomes.
“Sepsis can be deadly,” says Kath. “There was the thought that we might not get to keep Sadie, or because of where the infection was, she might be facing amputation.”
Ask, ‘Could this be sepsis?’
Timely diagnosis of sepsis saves lives. Medical practitioners, parents and carers of children should all be aware of and alert to the symptoms of sepsis. When a child is ill or injured ask, ‘Could this be sepsis?’. If there are no current signs of sepsis, continue to monitor the child’s condition for changes or deterioration.
Sadie’s support network, from the family’s GP who gave Kath the confidence to trust her instincts when it came to her daughter’s health, to the kindergarten teachers, her grandmother and finally the staff at Queensland Children’s Hospital, saved her life.
“We’re incredibly grateful that our kindy teachers were so on top of things, that my mum picked it up, and that our support network came together,” says Sadie. “I felt like I had the skills from our GP to work out when something was wrong, because of the education she’d always given me.”
Sepsis is an emergency; a child displaying any signs of sepsis should be taken to the nearest hospital Emergency Department. Parents and carers are encouraged to ask if sepsis is a possibility when talking to the medical staff who treat their child.
Watch Kath and Sadie tell their story here: Sepsis awareness: Kath and Sadie