Sepsis affects more than 40-50 million people worldwide each year, almost half are children. More than 18 children die from sepsis each day in the U.S.

This is more deaths than children who die from pediatric cancers. Many more children live with life-altering problems, such as amputations, organ dysfunction, post-traumatic stress disorder, and cognitive issues, to name a few. A recent study (2022) found that many children who received critical care for sepsis continue to have difficulties: “1 in 5 developed or had progression of a condition of interest after sepsis hospitalization, suggesting survivors of pediatric sepsis may benefit from structured follow-up to identify and treat new or worsening medical comorbid conditions.”

Although sepsis is the major cause of death within hospitals, up to 87% of sepsis cases originate in the community before patients are admitted. Any number of infections can trigger sepsis in school-aged children . This includes infected cuts and scrapes sustained on the playground, as well as infections, such as pneumonia, influenza, and meningitis. Many of these infections are preventable or treatable if caught in the earliest stages, thus reducing sepsis risk.

Two-thirds of children in the US who have severe sepsis also have an underlying chronic disease. Knowing this, professionals who work with compromised students can be aware of this increased risk. Half of affected children have an existing illness. Half have no predisposing factors for developing sepsis, yet they still get it – so awareness overall is paramount.

Parents of healthy children may choose not to vaccinate against childhood illnesses. These illnesses can lead to complications, including sepsis. For example, haemophilus influenzae type B (HIB), largely prevented by the HIB vaccine, causes nearly 400,000 deaths per year in the US; 15% of children who contract invasive HIB disease and bacteremia are over the age of 5 years and likely within the school system.

Meningitis affects children of all ages, but adolescents are at particular risk of contracting Neisseria meningitides. A routine vaccine may prevent the infection.

Of course, school-age children are also at risk of contracting the common childhood illnesses, such as pertussis and varicella.

Hand washing

Washing your hands is the best defense against contracting infections. But too many people – children and adults – don’t wash their hands effectively or frequently. Reminding staff about the importance of hand washing, as well as encouraging administration to make available waterless hand cleansers throughout the facility would likely increase compliance.

Students should also be reminded about the importance of hand washing. Soap and water should be readily available for them to do so. This simple step can help reduce the incidence of infection caused by bacterial infections, such MRSA, and viral infections, such as influenza.

Recognizing signs of infections

Every person who works with children knows the types of injuries and illnesses that can occur. When teachers and other staff members are knowledgeable about basic signs and symptoms of infections, they can be the ones to draw attention to the situation.

Here are some ideas that may help raise sepsis awareness in the schools:

Staff information sessions.

Teachers are not nurses and are not expected to be, but arming them with sepsis knowledge could save lives. The Sepsis 911 Information Kit, a program aimed towards the public, provides school nurses with a prepared presentation and a consistent message about what sepsis is, how it may be prevented, and how it is treated. The program is for the general public and has supporting materials for the presenters.

Sepsis and Children is a video describing how a boy developed sepsis and his progress from a previously healthy child to a young man with limb loss.

September is Sepsis Awareness Month, which  coincides with back-to-school. Back-to-school activities could include infection prevention and sepsis awareness.

Medical advances have allowed for people surviving illnesses that previously resulted in certain death. However, sometimes the survivors live with long-lasting and life-changing physical and medical challenges. As more children survive severe sepsis and septic shock, school nurses may see more children with complicated medical needs. These children may be struggling with any number of issues. These range from lasting effects of major surgery, amputations, dialysis, chronic pain/and or fatigue, hair loss, even PTSD. They may be unable to perform academically as they did before, or participate in activities, such as clubs and sports.

All these issues can present school nurses with challenges as they work with teachers, administrators, parents, and the children to develop care plans that will allow the children to continue with their education despite their recent health scare and current challenges.

To see an extensive list of conditions, ranging from chronic illnesses like diabetes to emergency situations like appendicitis, and their links to sepsis, please visit Sepsis and… at Sepsis.org.