Phoenix Sepsis Score
Evaluates for sepsis and septic shock in children.
Use in pediatric patients with suspected sepsis.
- Age is not adjusted for prematurity.
- Do not use in patients >18 years of age or those born preterm (<37 weeks gestation at birth).
- Do not use during birth hospitalizations.
Advice
- Goal-directed therapy (e.g. setting concrete goals for mean arterial pressure, oxygen saturation, and other physiologic indicators) can help improve survival.
- Antibiotic choice should be tailored to the suspected source or site of infection (if able to be determined) and the local antibiogram.
- Underlying conditions (e.g. malignancy, immunocompromise, cystic fibrosis, history of drug-resistant organisms) should also inform antibiotic choice.
Management
- Sepsis requires a score ≥2 in children with a suspected infection.
- Septic shock requires a score ≥2 plus ≥1 cardiovascular point.
- Follow your local standard of care for initiating treatment of sepsis and septic shock if supported by clinical condition; the Society of Critical Care Medicine’s Surviving Sepsis Campaign, maintains information on management and treatment of pediatric sepsis.
Critical Actions
- Patients with suspected septic shock should be admitted to a pediatric critical care unit.
- Hypotension is a late finding in children and signals impending cardiovascular collapse and cardiac arrest.
- Consider vasoactive agents if blood pressure remains hypotensive after 40–60 mL/kg of isotonic fluids.
- Vasoactive medications may be safely administered through a peripheral line initially if central access is unavailable, provided the site is monitored closely for signs of extravasation.