Práticas de enfermagem em crianças com sepse nos serviços de urgência e emergência: revisão de escopo

Autores/as

DOI:

https://doi.org/10.36517/2175-6783.20262796809

Palabras clave:

Cuidados de Enfermagem; Sepse; Enfermagem Pediátrica; Enfermagem em Emergência; Revisão de Escopo.

Resumen

Objetivo: mapear as práticas de enfermagem em crianças com sepse nos serviços de urgência e emergência. Métodos: revisão de escopo realizada nas bases: MEDLINE/PubMed, EMBASE, CINAHL, SCOPUS, Web of Science, LILACS, SciELO, Cochrane e literatura cinzenta: Google Scholar, ProQuest Dissertations & Theses, Catálogo de Teses e Dissertações e Biblioteca Digital Brasileira de Teses e Dissertações. Incluíram-se publicações de 2019 a 2025, selecionadas por dois revisores. Resultados: dos 6.155 estudos identificados, 11 compuseram a amostra. Predominaram produções tecnológicas e estudos transversais (n=3; 27%), publicados em 2019 (n=3; 27%). Nos serviços de urgência e emergência, as práticas de enfermagem incluíram assistência direta (n=3; 27%), com reconhecimento precoce da deterioração clínica, monitorização, acesso vascular e administração de antimicrobianos e fluidos; educação profissional (n=4; 36%), com realidade virtual, simulação e tecnologias educacionais; e gerenciamento (n=4; 36%), com ferramentas de triagem, sistemas de alerta e protocolos assistenciais. Conclusão: as evidências indicam que as práticas de enfermagem se concentram na vigilância, tratamento oportuno, capacitação profissional e gerenciamento do cuidado à criança com sepse nos serviços de urgência e emergência. Contribuições para a prática: os achados podem subsidiar a capacitação das equipes e a implementação de protocolos para reconhecimento e manejo da sepse pediátrica nesses serviços.

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Referencias

1. Schlapbach LJ, Watson RS, Sorce LR, Argent AC, Menon K, Hall MW, et al. International consensus criteria for pediatric sepsis and septic shock. JAMA. 2024;331(8):665. doi: https://doi.org/10.1001/jama.2024.0179

2. Weiss SL, Fitzgerald JC. Pediatric sepsis diagnosis, management, and sub-phenotypes. Pediatrics. 2024;153(1):e2023062967. doi: https://doi.org/10.1542/peds.2023-062967

3. Watson RS, Carroll ED, Carter MJ, Kissoon N, Ranjit S, Schlapbach LJ, et al. The burden and contemporary epidemiology of sepsis in children. Lancet Child Adolesc Health. 2024;8(9):670-81. doi: http://doi.org/10.1016/S2352-4642(24)00140-8

4. Franco MC, Niño-Serna LF, Rendón M, Betancourt M, Torres C, Maya IC. Caracterización y factores pronósticos de pacientes con sepsis en un hospital de alta complejidad. Andes Pediatr. 2023;94(3):297-305. doi: https://doi.org/10.32641/andespediatr.v94i3.4338

5. David C, Silva VM, Ventura LS, Silveira JRD, Barlem ELD, Ilha S, et al. Characteristics of patients with sepsis and/or septic shock admitted to an adult intensive care unit. Rev Rene. 2025;26:e94993. doi: https://doi.org/10.36517/2175-6783.20252694993

6. Azevedo LCP, Besen BAM, Ramos FJS, Machado FR. Sepse. Rio de Janeiro: Atheneu; 2024.

7. Esposito S, Mucci B, Alfieri E, Tinella A, Principi N. Advances and challenges in pediatric sepsis diagnosis: integrating early warning scores and biomarkers for improved prognosis. Biomolecules. 2025;15(1):123. doi: http://dx.doi.org/10.3390/biom15010123

8. Harley A, Schlapbach LJ, Johnston ANB, Massey D. Challenges in the recognition and management of paediatric sepsis: the journey. Australas Emerg Care. 2022;25(1):23-9. doi: https://doi.org/10.1016/j.auec.2021.03.006

9. Hansen M, Gillespie J, Riddick T, Samatham R, Baker S, Filer S, et al. Evaluation of electronic measurement of capillary refill for sepsis screening at ED triage. Am J Emerg Med. 2023;70:61-65. doi: https://doi.org/10.1016/j.ajem.2023.05.009

10. Chua WL, Teh CS, Basri MAB, Ong ST, Phang NQQ, Goh EL. Nurses’ knowledge and confidence in recognizing and managing patients with sepsis: a multi-site cross-sectional study. J Adv Nurs. 2023;79(2):616-29. doi: http://doi.org/10.1111/jan.15435

11. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: scoping reviews. In: Aromataris E, Munn Z, editors. JBI manual for evidence synthesis. Adelaide: The Joanna Briggs Institute; 2020. doi: https://doi.org/10.46658/JBIMES-20-12

12. Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z. JBI Manual for Evidence Synthesis. Adelaide: Joanna Briggs Institute; 2024. doi: https://doi.org/10.46658/JBIMES-24-01

13. Lanziotti VS, Ventura AMC, Kache S, Fernández-Sarmiento J. New Phoenix criteria for pediatric sepsis and septic shock: the strengths and the future of a comprehensive perspective. Crit Care Sci. 2024;36:e20240058en. doi: https://doi.org/10.62675/2965-2774.20240058en

14. Sanchez-Pinto LN, Bennett TD, DeWitt PE, Russell S, Rebull MN, Martin B, et al. Development and validation of the Phoenix criteria for pediatric sepsis and septic shock. JAMA. 2024;331(8):675-86. doi: https://doi.org/10.1001/jama.2024.0196

15. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. doi: https://doi.org/10.1136/bmj.n71

16. Melnyk BM, Gallagher-Ford L, Fineout-Overholt E. Implementing the evidence-based practice (EBP) competencies in healthcare: a practical guide for improving quality, safety, and outcomes. Indianapolis (IN): Sigma Theta Tau International; 2016.

17. Mittal Y, Sankar J, Dhochak N, Gupta S, Lodha R, Kabra SK. Decreasing the time to administration of first dose of antibiotics in children with severe sepsis. J Healthc Qual. 2019;41(1):32-8. doi: https://doi.org/10.1097/JHQ.0000000000000141

18. Harley A, Johnston ANB, Denny KJ, Keijzers G, Crilly J, Massey D. Emergency nurses’ knowledge and understanding of their role in recognising and responding to patients with sepsis: a qualitative study. Int Emerg Nurs. 2019;43:106-12. doi: https://doi.org/10.1016/j.ienj.2019.01.005

19. Emerson BL, Ciaburri R, Brophy C, Kandil SB. Decreasing time to antibiotics for patients with sepsis in the emergency department. Pediatr Qual Saf. 2019;4(3):e173. doi: https://dx.doi.org/10.1097/pq9.0000000000000173

20. Silva JR. Desenvolvimento de vídeo educativo para o atendimento de enfermagem em emergência pediátrica decorrente de choque séptico [Internet]. Ribeirão Preto: Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo; 2020 [cited Apr 22, 2026]. Available from: https://www.teses.usp.br/teses/disponiveis/22/22133/tde-06072020-162628/pt-br.php

21. Eisenberg MA, Balamuth F. Pediatric sepsis screening in US hospitals. Pediatr Res. 2022;91(2):351-8. doi: https://dx.doi.org/10.1038/s41390-021-01708-y

22. Harley A, Schlapbach LJ, Lister P, Massey D, Gilholm P, Johnston ANB, et al. Knowledge translation following the implementation of a statewide paediatric sepsis pathway in the emergency department: a multi-centre survey study. BMC Health Serv Res. 2021;21(1):1161. doi: https://doi.org/10.1186/s12913-021-07128-2

23. Scott HF, Kempe A, Bajaj L, Lindberg DM, Dafoe A, Dorsey-Holliman B, et al. “These are our kids”: qualitative interviews with clinical leaders in general emergency departments on motivations, processes, and guidelines in pediatric sepsis care. Ann Emerg Med. 2022;80(4):347-57. doi: https://doi.org/10.1016/j.annemergmed.2022.05.030

24. Auerbach MA, Whitfill T, Montgomery E, Leung J, Kessler D, Gross IT, et al. Factors associated with improved pediatric resuscitative care in general emergency departments. Pediatrics. 2023;152(2):e2022060790. doi: https://dx.doi.org/10.1542/peds.2022-060790

25. Oddiri U, Propper G, Brill P, Reid B, Giarraputo D, Milana C. Early identification of severe sepsis in pediatric patients using an electronic alert system. Hosp Pediatr. 2023;13(2):174-82. doi: https://doi.org/10.1542/hpeds.2022-006587

26. Zackoff MW, Cruse B, Sahay RD, Zhang B, Sosa T, Schwartz J, et al. Multiuser immersive virtual reality simulation for interprofessional sepsis recognition and management. J Hosp Med. 2024;19(3):185-92. doi: https://dx.doi.org/10.1002/jhm.13274

27. Kadish CB, Lloyd JK, Adelgais KM, Ward CE, Lo CB, Truelove A, et al. Prehospital recognition and management of pediatric sepsis: a qualitative assessment. Prehosp Emerg Care. 2023;27(6):775-85. doi: https://doi.org/10.1080/10903127.2023.2210217

28. Gholipour M, Dadashzadeh A, Jabarzadeh F, Sarbakhsh P. Challenges of clinical decision-making in emergency nursing: an integrative review. Open Nurs J. 2025;19:e18744346378311. doi: https://doi.org/10.2174/0118744346378311250320070725

29. Fisler G, Brewer MR, Yaipen O, Deutschman CS, Taylor MD. Age influences the circulating immune profile in pediatric sepsis. Front Immunol. 2025;16:1527142. doi: https://doi.org/10.3389/fimmu.2025.1527142

30. Moreira DAA, Braga DV, Viana MCA, Oliveira DR, Oliveira CJ, Cavalcante EGR. Nursing care to patients with sepsis: analysis in the light of Myra Levine’s conceptual model. Esc Anna Nery. 2022;26:e20210368. doi: https://dx.doi.org/10.1590/2177-9465-EAN-2021-0368

31. Ramgopal S, Martin-Gill C, Michelson KA. Pediatric vital signs documentation in a nationally representative US emergency department sample. Hosp Pediatr. 2024;14(7):532-40. doi: https://doi.org/10.1542/hpeds.2023-007645

32. Workman JK, Keenan HT, Weir CR. Pediatric septic shock care pathways in general emergency departments: a qualitative study targeting how to really make it work. Pediatr Emerg Care. 2023;39(8):562-8. doi: https://doi.org/10.1097/PEC.0000000000002910

33. Karageorgos S, Hibberd O, Ren D, Hornsby Y, Roland D, Koutroulis I. Training for pediatric sepsis: a medical education perspective and potential role of artificial intelligence. Children (Basel). 2025;12(11):1542. doi: https://doi.org/10.3390/children12111542

34. Sears SM, Coughlin AK, Nelson K, Stillwell T, Carlton EF, Flori HR. Barriers and facilitators to effective electronic health record-based sepsis screening in the pediatric intensive care unit. JAMIA Open. 2024;7(3):ooae048. doi: https://doi.org/10.1093/jamiaopen/ooae048

35. Souza DC, Paul R, Mozun R, Sankar J, Jabornisky R, Lim E, et al. Quality improvement programmes in paediatric sepsis from a global perspective. Lancet Child Adolesc Health. 2024;8(9):695-706. doi: http://doi.org/10.1016/S2352-4642(24)00142-1

36. McCarthy B, Middleton N, Gill FJ, Goff Z, Paterson Z, Blyth CC. Impact of an evidence-based sepsis pathway on paediatric hospital clinical practice: a quality improvement study. Emerg Med Australas. 2025;37(2):e70036. doi: https://dx.doi.org/10.1111/1742-6723.70036

37. Gilholm P, Gibbons K, Lister P, Harley A, Irwin A, Raman S, et al. Validation of a pediatric sepsis screening tool to identify children with sepsis in the emergency department: a statewide prospective cohort study in Queensland, Australia. BMJ Open. 2023;13(1):e061431. doi: https://doi.org/10.1136/bmjopen-2022-061431

38. Dewi DDSA, Suprihatiningsih S, Soselisa AH, Cealy FR, Nuha MU, Sandi NC, et al. Automated alerts systems for pediatric sepsis patients: a systematic review. J Nursology. 2025;28(2):206-14. doi: https://doi.org/10.17049/jnursology.1524051

39. Abdalhafith O, Rababa M, Hayajneh AA, Alhusban F, Alrjoub S, Al-Hadid L, et al. Critical care nurses’ knowledge, confidence, and clinical reasoning in sepsis management: a systematic review. BMC Nurs. 2025;24:424. doi: https://doi.org/10.1186/s12912-025-02986-1

Publicado

2026-08-07

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Os autores declaram que os dados estão disponíveis de forma completa no corpo do artigo.

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Artigos de Revisão

Cómo citar

1.
Lohn A, Nascimento ERP do, Nascimento KC do, Malfussi LBH de, Moreira AR, Vieira PM, et al. Práticas de enfermagem em crianças com sepse nos serviços de urgência e emergência: revisão de escopo. Rev Rene [Internet]. 2026 Aug. 7 [cited 2026 Aug. 11];27:e96809. Available from: https://periodicos.ufc.br/rene/article/view/96809