Name: Paediatric sepsis: diagnosis, antimicrobial treatment and source control — branching viva
Creator: MedVellum
Published: 2026-07-12

Paediatric sepsis: diagnosis, antimicrobial treatment and source control — branching viva

A branching structured oral following one child with evolving septic shock from recognition through the first-hour bundle, fluid and vasoactive escalation, source control, reassessment, retrieval and disposition, with evidence and regional boundaries tested throughout.

branching clinical structured oral4 min readVerification in progress

Prompt

A four-year-old child presents to a regional emergency department with fever, mottling, tachycardia and altered behaviour. The examiner releases information in stages. The candidate must classify the syndrome with the Phoenix criteria, deliver a first-hour bundle, escalate fluid and vasoactive therapy with reassessment, arrange source control, and retrieve safely.

Station status

This is one MedVellum formative branching structured oral. The prompts and performance descriptions are educational feedback tools; they are not an official college examination format, mark allocation, pass score or reproduced station. The viva assesses Phoenix-criteria classification, the first-hour bundle, fluid and vasoactive escalation with reassessment, source control, and safe retrieval. [3] [11]

Paediatrics Fellowship Pro

You have read the opening of this viva. The complete unit — every section and its primary-source references — is part of the Paediatrics Fellowship fellowship atlas.

References9Show ledger

[1]Sanchez-Pinto LN, Bennett TD, DeWitt PE, et al. Development and Validation of the Phoenix Criteria for Pediatric Sepsis and Septic Shock. JAMA, 2024.PMID 38245897
[2]Schlapbach LJ, Watson RS, Sorce LR, et al. International Consensus Criteria for Pediatric Sepsis and Septic Shock. JAMA, 2024.PMID 38245889
[3]Weiss SL, Peters MJ, Oczkowski SJW, et al. Surviving Sepsis Campaign International Guidelines for the Management of Sepsis and Septic Shock in Children 2026. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies, 2026.PMID 41869844
[8]Maitland K, Kiguli S, Opoka RO, et al. Mortality after fluid bolus in African children with severe infection. The New England journal of medicine, 2011.PMID 21615299
[9]Inwald DP, Canter R, Woolfall K, et al. Restricted fluid bolus volume in early septic shock: results of the Fluids in Shock pilot trial. Archives of disease in childhood, 2019.PMID 30087153
[11]Paul R, Niedner M, Riggs R, et al. Bundled Care to Reduce Sepsis Mortality: The Improving Pediatric Sepsis Outcomes (IPSO) Collaborative. Pediatrics, 2023.PMID 37435672
[12]Bjorklund A, Resch J, Slusher T Pediatric Shock Review. Pediatrics in review, 2023.PMID 37777656
[13]Rutman L, Richardson T, Auletta J, et al. Association between Child Opportunity Index and paediatric sepsis recognition and treatment in a large quality improvement collaborative: a retrospective cohort study. BMJ quality & safety, 2026.PMID 40345682
[16]Balamuth F, Weiss SL, Long E, et al. Balanced Fluid or 0.9% Saline in Children Treated for Septic Shock. The New England journal of medicine, 2026.PMID 42028918