The signs of Sepsis you NEED to know about

I recently had a very scary experience. I had a chest infection, but suddenly I couldn’t breathe. I’m asthmatic, so I’m used to some difficulties, but this was different; it was like I was fighting for every breath. I had a high fever and was deathly pale. I was taken to hospital in an ambulance, where they did their observations and realised my temperature had gone up another degree in the 15 minutes it had taken to get to the hospital. My heart rate was 135 bpm, I was shivering like crazy and I just felt like I wanted to sleep. I was immediately diagnosed with suspected sepsis and put on IV antibiotics.

Thankfully after hours and hours my temperature and vital signs were normal enough for me to be allowed home with antibiotics and steroids, and instructions to check in with my GP every few days for the next week.

Sepsis is a serious complication of an infection.

Sepsis in children under 5

Call 999/911 IMMEDIATELY if you notice any of these symptoms in your child

  • Has a convulsion or fit
  • Is difficult to wake or lethargic
  • Looks mottled or blue
  • Feels abnormally cold
  • Is breathing very fast
  • Has a rash that does not fade when pressed

You should get medical advice straight away if you notice any of these symptoms

Sepsis in older children and adults

You may also notice

  • High fever or low body temperature
  • Fast heart rate
  • Increased breathing rate
  • Loss of consciousness
  • Nausea and vomiting

It’s important to act quickly if you’ve got an infection and think you or someone else may have Sepsis. Sepsis can lead to multiple organ failure and death if not treated quickly.

Treatment and recovery

In the UK, hospitals use the ‘sepsis 6’. This means

  1. Antibiotics, either through an IV or tablets at home if the infection is caught early enough
  2. Oxygen if your oxygen saturation levels are low
  3. Giving IV fluids
  4. Look at your urine to check your kidneys are working
  5. Take a blood sample to see how severe the sepsis is
  6. Take a blood culture to find out which bacteria is causing the sepsis

Some people recover very quickly from sepsis, but it does depend on the person’s overall health, the severity of the infection, and how much time was needed in the hospital (including the ICU). People with severe sepsis or septic shock often require admission to the ICU, and are likely to be very ill. In this case the condition can be fatal.

The main takeaway from this is that Sepsis is a serious medical condition, but if caught early enough, most people recover with no lasting issues.

Do you know the symptoms of Sepsis?

Sources used – NHS Scotland , Sepsis Trust

Tips and tricks for tummy bug troubles

Unfortunately, it’s the time of year where stomach bugs are rife. I was recently in the hospital twice in the space of two days, as my little one had a severe case of gastroenteritis. While I was there, I had many in depth conversations with paediatricians, nurses and the matron, who gave me many materials and ideas about the prevention and management of gastroenteritis, and how to recognise the signs of dehydration.

Gastroenteritis (or more commonly known as the ‘tummy bug’) is an infection of the intestines and stomach which causes vomiting and diarrhoea (D&V). It is often caused by infections like the norovirus, or rotavirus, though it can also be bacterial.
D&V caused by tummy bugs is common in children younger than 5, however lots of diarrhoea and vomiting can cause dehydration, which is a serious complication. This is unusual, and most children can be cared for at home following advice from a qualified healthcare provider.  In most cases, diarrhoea usually lasts 5-7 days and has come to an end by 2 weeks, while vomiting usually only lasts between 1-3 days.
While we were at the hospital, the paediatrician told me that parents should avoid taking their children to the GP if they suspect gastroenteritis, as it is spread so quickly and easily. Instead, parents should call 111 (UK) or their GP if they are concerned. Just to recap, the symptoms of gastroenteritis are:
  • feeling sick
  • sudden, watery diarrhoea,
  • mild fever
  • vomiting, which can be projectile
  • abdominal craps
  • poor appetite

When to seek medical advice for your child

As gastroenteritis is spread so quickly, it is best to care for your child at home to avoid infecting others. However, you should seek medical assistance if your child:
  • has blood in their poo, or green vomit
  • has been vomiting for three days or more
  • has had diarrhoea for more than a week
  • has a serious underlying condition and also has D&V
  • has symptoms of dehydration –
    • sunken eyes
    • cold extremities
    • mouth and lips appear dry
    • seems to be getting worse, will not take fluids or vomits immediately after drinking
    • are floppy, unresponsive or lethargic
    • skin appears to be more baggy than usual
    • much higher pulse rate than usual
    • they have had more than 8 loose nappies per day
    • they do not have more than 2 wet nappies per day
    • no tears when crying
    • sunken fontanelle in babies

Preventing the spread

  1. Children should not attend any kind of childcare or school while they have vomiting or diarrhoea, and should not return until at least 48 hours have passed since the last episode of vomiting or diarrhoea.
  2. Hand washing is the best way to prevent the spread of gastroenteritis. This includes the obvious times, like after using the toilet, changing nappies, or touching food. Do not rely on alcohol hand gels.
  3. Towels and other personal items should not be shared between children or other members of the family while someone is suffering with gastroenteritis.
  4. Children should not use a swimming pool for 14 days after their last episode of diarrhoea.
  5. Disinfect any surfaces and items that could be contaminated.

Treatment

Most cases of gastroenteritis can be treated at home, with supervision from medical professionals in more severe cases.
Children should be encouraged to drink plenty of fluids, even if it is only small sips at a time. Breastfed babies should continue to be breastfed as long as they are tolerating the breast milk.
Oral Rehydration Solutions (ORS) such as dioralyte may be used, which is available without prescription from a pharmacy or supermarket.
A note on liquids – liquids are absorbed by the body very quickly, so if your child vomits ten minutes after drinking, it is highly likely that most of the fluids have already been absorbed by the body, and fluids should continue to be given.

Children who are vomiting

Small sips of liquid should be given to begin with, and if this is not vomited, the amount can be increased. Generally the amount of liquid a child should aim for in this phase is 1.5 to 2.5 oz per lb of body weight in a 24 hour period – for example we were told to aim for 1oz per hour for my little one. Once the vomiting lessens, a more normal diet may be trialed the next day. We found it easiest to start giving 5-10mls every 5 minutes, and did so using a bottle we would have usually used for milk – ORS can be kept in the fridge for 24 hours after mixing it from a sachet, and it is both easier to monitor intake, and less messy on your child’s part!

Children who have diarrhoea but little vomiting

These children should be given more liquid to combat the liquid lost through loose stools. However, this liquid can be given in larger, less frequent amounts, and children can attempt to continue their normal diet. If your child has significant diarrhoea, it is advisable to stop dairy products during this time as these foods can make diarrhoea worse.
 
While it can seem really daunting to care for your child while they’re unwell, rest assured that gastroenteritis is very common. There are around 5 billion cases of it every year worldwide, so you’re not alone.
What have your experiences of the tummy bug been like?
 
Sources:
Cochran, W. (2018). Gastroenteritis in Children – Children’s Health Issues – MSD Manual Consumer Version. [online] MSD Manual Consumer Version. Available at: https://www.msdmanuals.com/en-gb/home/children-s-health-issues/digestive-disorders-in-children/gastroenteritis-in-children [Accessed 14 Oct. 2018].
 
Nhsinform.scot. (2018). Gastroenteritis. [online] Available at: https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/gastroenteritis [Accessed 14 Oct. 2018].
 
Nice.org.uk. (2009). Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management | Guidance and guidelines | NICE. [online] Available at: https://www.nice.org.uk/guidance/cg84 [Accessed 14 Oct. 2018].
Technology, H. (2018). Home. [online] East Sussex Healthcare NHS Trust. Available at: http://www.esht.nhs.uk/ [Accessed 14 Oct. 2018].
 
With thanks to helpful conversations for the staff on Kippling ward, ESHT.

Pyloric Stenosis: when vomiting isn’t just reflux

If you’re reading this, chances are you have (or have had) a very ‘sicky’ baby. Chances are, your friends and family told you ‘it’s just reflux’. And fair enough, it might be. But it might not be. If you’re not convinced, read on to find out more.

My little monkey was always a very ‘sicky’ child. Ever since she was born, she’d be sick after every feed. While that sounds normal, the amount of sick wasn’t. She’d always vomit up at least half of her bottle, and then cry because she was hungry. We endured it for 3 weeks before we insisted on her having a medical assessment. She was diagnosed with a dairy allergy, and we were told that a hypoallergenic milk prescription would fix the issue. It didn’t. We took her back to our doctor countless times, and were berated for wasting GP time as she just ‘had reflux’. We tried countless reflux medications, but everything just seemed to make the issue worse.

Once my little one had reached 7 weeks, I’d had enough. After an evening of being covered in around 18oz of projectile vomit, I took her to A&E and insisted they run blood tests on my daughter. Sure enough, they diagnosed her with Pyloric Stenosis.

Pyloric Stenosis is a condition in which the valve allowing food to pass from the stomach to the intestine becomes too thick, and the hole closes. This means that nothing can get through, which leads to malnutrition, dehydration, and even death. Symptoms include extreme vomiting, lethargy, constipation, and less wet nappies.

Once admitted to hospital, we had to watch an NG tube be placed into our little one, to drain her stomach. She had an IV inserted to keep her fluid intake up, along with some vitamins, but she wasn’t allowed to eat. We were in hospital for 3 days in total before she had her operation, and we weren’t allowed to feed her anything, which was torture when she cried.

Eventually, we were transferred by blue light ambulance to a specialist children’s hospital for her to have laparoscopic surgery. The surgery took around an hour, and my little soldier had 3 doses of infant paracetamol in total during recovery. (What a brave little thing, adults have doses of morphine after similar surgeries).

Luckily, after having her surgery, the Pyloric Stenosis was cured and we never had to return to hospital for the same issue, however, others aren’t so lucky. PS can recur in 1% of cases, and for some people, it becomes a chronic issue which requires constant returning to hospital.

All in all, we were very lucky. Honestly, I think my stubborn nature went a long way in getting her diagnosed, as before I put my foot down, doctors were dismissing me as the ‘hypochondriac mum’.

What can we take away from this? Well,

1) Trust your instincts.
Mother’s intuition is REAL, and it can save you so much bother if you listen to it. If you think something is wrong with your little one, get them checked. The worst that can happen is that a qualified professional can explain to you (at length, if needed) that your baby is healthy, and reassure you.

2) Know your stuff.
While doctors often chastise patients for having a look at good old Doctor Google, sometimes it is your ally, and a tool to be used. Before Mini Me was diagnosed, a doctor incredulously asked me “what do you think is wrong with her then?” When I replied ‘Pyloric Stenosis’, a lightbulb obviously went off for him. He ordered several blood tests and an ultrasound, and sure enough, she was diagnosed. While I’m not saying that you should use Google for everything, but when you’ve been having the same issue for weeks, nothing seems to be helping and things aren’t adding up, maybe you should consider it.

3) Be kind to yourself.
While we were in hospital, I went through a phase of blaming myself for my monkey’s illness. As a mum, its only natural to want to fix things, but some things can’t be fixed by guilt. No, most things can’t be fixed by guilt. I felt awful for the fact I hadn’t put my foot down sooner, but eventually, I was just glad that I had done it at all. I often think about what would have happened if I hadn’t said anything to our doctors, and I’m so glad I did, because the outcome could have been so much worse.

Unfortunately, Pyloric Stenosis can’t be prevented, but it can be cured, and more new mums should know that it exists. If your little one is struggling with vomiting, especially in the first few weeks, please get them checked out, and if you’re unsure, get a second opinion. While Pyloric Stenosis is rare, it isn’t worth excluding as an option.

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7 Actual Important Things all Pregnant Women Need to Know…

There are so many practical things no body ever told me when I was pregnant and I never even thought to ask  – You don’t know what you don’t know, right? 

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I see a lot of posts on this subject that focus on the funny side, about how everyone will see your nakedness and you won’t care, about how you’ll get used to being puked on etc etc.  This post isn’t that, there are so many practical things no body ever told me when I was pregnant and I never even thought to ask  – You don’t know what you don’t know, right? 
 
So, here is MY personal list of really important things that I should have been told, I’d love to hear yours in the comments!

1. Group B Strep 

It’s strange, I was asked several times on the maternity ward whether I was Strep B Positive and I always assumed that I must have been tested or they wouldn’t be asking (after all, they nicked enough of my blood for testing over the course of my pregnancy) I also assumed I must have been all clear or they would have told me. WRONG. It wasn’t until Harriet got her results that I found out what it is and why it is so crucial for EVERY mother to be tested in EVERY pregnancy. (Read her story here)
 

2. Your birth might not go according to plan

Okay, thats a pretty obvious one and I guess on some level we all know that but what I mean is that no one told me exactly what it was that could go wrong and how that might be resolved. Nobody prepared me for emergency procedures in theatre. I suppose nobody wants to scare a pregnant woman, well, I’m gonna do it. You might have to have major abdominal surgery. You might have to have your lady bits sliced and diced. Your lady bits might rip and you could lose a lot of blood. If you are pregnant I would strongly advise you to talk to your midwife (or relevant healthcare professional) about what you can expect if you need to have an emergency procedure. What the risks are, why they happen and what you have to sign when they thrust the surgical permission slip at you between contractions. It’s going to be easier to take that information on board when you aren’t 15 hours into labour and drifting in an out of consciousness.
 

3. Packing for hospital stays 

I see a lot of posts about hospital bag essentials. I disregarded most of them because they contain bluetooth speakers, tablets and essential oils. I packed a small bag of actual essentials (clothes for me, clothes for baby, nappies, sports drink, vaseline, maternity pads, granny pants, phone charger, hospital notes) which would have been absolutely fine if my birth had  gone smoothly and my son wasn’t crazy jaundiced. My poor husband was back and forth with clothes and supplies all week. He doesn’t drive so he was walking three miles to the hospital and three miles home (what a trooper). So, pack a bag for if things go to plan. Pack another, bigger bag for if they don’t. Oh, and hospitals don’t give you shampoo. 
 

4. Tongue tie (and other feeding issues)

This is a huge deal to me and I will be talking about it in more detail in another post soon. I did hear tongue ties mentioned when I was pregnant. ONCE. It was in the following context; “You can’t breastfeed a baby with tongue tie because they can’t latch to the breast”. This is possibly the single worst piece of misinformation I was given. My son had a tongue tie and he latched and fed, just not very well. None of the midwives or health visitors picked up on it and I had no idea what to look for. I was supported by amazing local services which are now facing massive budget cuts (see their campaign here) but I wish I had gone to see them when I was pregnant for some advice and again after my son was born before I was told that his behaviour was normal or that it was my fault.
 

5. Nappies

You are going to be changing a LOT of nappies. I decided to use cloth when I was pregnant but my dinky baby didn’t fit in them to start with. If I had realised just how many disposable nappies we’d get through in the first three months (around 900) I would have invested in some smaller sized cloth nappies. Obviously a lot of people told me that it would be a lot but the actual figures still startled me. If you’re in the UK you can find your local cloth nappy library here.

6. How and when to bathe a newborn 

This one was a source of panic for me from around 20 weeks. I asked at an antenatal class but I was shown with a rigid toy doll and no actual water so I was ill prepared. When I was presented with a mucky baby fresh out of the womb I had no idea if I should be washing the gunk off of him and how I might go about that. I avoided it for a while and picked the crispy bits of womb lining out of his perfect hair as best I could. He was eventually washed for first time at a week old by a lovely member of the maternity ward team who talked me through top and tailing. I still had no idea how to give him an actual bath so I just didn’t, for weeks. I’m still not 100% sure but if you’re concerned I hope you find comfort in the fact that it isn’t just you.
 

7. Dressing your baby 

How do you get those tiiiiny little vests over the head of a baby with zero muscle control? (Answer – you put the head hole under the back of their head and pull it gently over the top). As silly as it sounds, no one ever told me or showed me and I had not slept much so how was I to know? It took me a week to figure it out – luckily I have a summer baby. He lived in fully poppered sleepsuits most of the time. Also, everyone kept telling me I needed a going home outfit for him and that is a lie. I needed a clean sleep suit for him to go home in. I did pack an outfit but he was too tiny and I didn’t care one bit, I just wanted to get home.
 
I’m sure I’ve missed some because… well because my son is two and my brain is mush from all the parenting. As a bonus, I asked my husband what he wished he’d known. Apparently he’s quite traumatised. Here is his list:
 

Labour is terrifying

Seeing your partner in labour, in that much pain and not being able to help is awful. Seeing them in theatre and having to hold it together when you’re worried you might lose the woman you love and your child is the scariest thing. 
 

Babies are terrifying

How do you hold them with out breaking them? How do you change nappies? Dress them? Undress them? Put them in the carseat? Pick them up? Put them down? HOW?
 

The weight of the world is terrifying

Your partner just made a small human. She is in no position to do anything much so you’ve just gone from being responsible for yourself to being responsible for you, your wife and your baby… and all of the cooking and cleaning. Two weeks in and you have to work again. It’s a massive adjustment to make and it can be a little overwhelming.

The soft spot is terrifying

Every time you touch the soft spot you think you’ve hurt your child. Absolutely. terrifying. 

 


If you liked this you may enjoy reading…

harriet labour
 
 
sarah birth story
 
tongue tie
 
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Mummies Waiting

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