- Robert Preidt
- Posted July 24, 2018
New Hope in Saving Kids From Blood Infection Sepsis
In 2012, Rory Staunton, a 12-year-old living in New York City, became ill after an innocuous scrape to his arm during basketball practice.
Five days later Rory was dead, killed after bacteria from the cut made its way into his bloodstream and set up an immune response known as sepsis, which attacked and overwhelmed vital organs.
With an earlier diagnosis, it's possible Rory could have lived.
His parents, Orlaith and Ciaran Staunton, turned their grief into action, and pushed hard for updated New York state sepsis diagnosis protocols.
Now, new research shows that those protocols, dubbed "Rory's Regulations," are helping to save other kids' lives.
The study of almost 1,200 New York state children has found that completion of the sepsis protocol within one hour reduced the risk of death by 40 percent.
"No child should die from a treatable infection," said study senior author Dr. Christopher Seymour. He's associate professor of critical care medicine at the University of Pittsburgh.
"This is the best evidence to date that prompt identification and treatment of suspected sepsis leads to better outcomes in children," Seymour said.
For Orlaith Staunton, who helped found the Rory Staunton Foundation, the news is gratifying.
"Although it is too late for our beloved Rory, we call to action all physicians and medical institutions to demand that Rory's Regulations be adopted in every clinical setting," she said. "These are bare bone precautions, not requiring an arduous FDA approval process. The cure is right in front of our eyes ... We want other families to be spared this horrific tragedy. It is what Rory would have wanted most of all."
According to emergency medicine physician Dr. Nicole Berwald, sepsis is a life-threatening condition involving a severe infection that's spread through the bloodstream.
"In the body's attempt to fight the infection, the immune system's response can lead to damage to the patient's organs and tissues, which can lead to death if not treated promptly," said Berwald, who is interim chair of emergency medicine at Staten Island University Hospital in New York City.
"Both children and adults are subject to this condition," said Berwald, who wasn't involved in the new study.
According to Seymour's team, about one in every 10 children hospitalized with sepsis will die.
In the new study, researchers tracked outcomes for 1,179 children, average age just over 7 years, who were treated for sepsis at 54 New York hospitals. Of those children, 139 died.
Completion of the sepsis protocol within one hour reduced the risk of death by 40 percent, the study team reported July 24 in the Journal of the American Medical Association.
Completion of the guidelines was crucial. When only parts of the protocol were completed within an hour -- for example, giving fluids but not testing for infection or giving antibiotics -- there was no decline in the risk of death, the team noted.
The researchers hope their findings will encourage other states to adopt similar protocols.
Dr. Clifford Deutschman is vice chair of research in pediatrics at Cohen Children's Medical Center in New Hyde Park, N.Y. He said it's important to note that sepsis in children and adults can differ.
"The findings in children differ from those identified in a similar analysis on adults performed by the same investigators," he said.
For her part, Berwald said there are key signs parents can look for if they suspect sepsis in a child, and these signs can vary by age.
"In very young babies, they may just not look right to the caregiver. They may have fever or be irritable or fussy. Other signs are if the child won't eat or looks like they are having difficulty breathing," she said.
"Older children may also show these same symptoms and may seem confused, ill, or complain that they feel their heart is racing," Berwald said. "Another thing to note is if the child has an infection, but they seem not to be getting better or if they are getting worse. It would be prudent to contact the pediatrician or be seen at the hospital in these instances."
Deutschman added that today's parents owe a debt of gratitude to Orlaith and Ciaran Staunton.
"They have made it their life's mission to assure that, at some point in the future, what happened to their son will never happen again," he said. "Only true heroes can use a personal tragedy as an impetus to make the world -- or at least New York -- a better place. The Stauntons are doing it, one state at a time. And we are all better off because of them."
There's more on sepsis and its warning signs at the Rory Staunton Foundation.
SOURCES: Nicole Berwald, M.D., interim chair, emergency medicine, Staten Island University Hospital, New York City; Clifford S. Deutschman, M.D., vice chair, research, department of pediatrics, Cohen Children's Medical Center, New Hyde Park, N.Y.; Orlaith Staunton; University of Pittsburgh, news release, July 24, 2018