Browse categories and answer follow-up questions to refine your symptom profile.
Triage priorities
High-risk age group
0 to 28 days with rectal temperature 38.0 C or higher
Serious bacterial infection risk even if well appearing
Treat as sepsis until proven otherwise
Immediate escalation triggers
Apnea
Cyanosis
Poor perfusion
Lethargy
Seizure
Hypotension
Initial monitoring
Continuous pulse oximetry
Cardiac monitor
Noninvasive blood pressure cycling
Temperature trend
Stabilization
Airway and breathing
Supplemental oxygen for SpO2 below local target
Bag-mask ventilation for apnea or inadequate ventilation
Early airway support for recurrent apnea or shock
Circulation
Vascular access within 5 minutes
Peripheral IV
If delayed, intraosseous
Fluid resuscitation
If shock, isotonic crystalloid 10 mL/kg bolus
Reassess after each bolus
Additional boluses up to 40 mL/kg in first hour if persistent shock and no fluid intolerance
Vasoactive support
If fluid-refractory shock, epinephrine infusion per local protocol
If cold shock with low cardiac output, epinephrine favored
If warm shock with low SVR, norepinephrine favored
Glucose and temperature
Hypoglycemia threshold 2.6 mmol/L
Dextrose bolus if 2.6 mmol/L or lower
D10W 2 mL/kg IV
Hypothermia and hyperthermia as sepsis markers
Sepsis bundle timing
Time zero
First documented rectal temperature 38.0 C or higher
First clinician recognition of sepsis physiology
Antibiotics
Within 60 minutes of sepsis recognition
After cultures if no delay
Lumbar puncture timing
Before antibiotics if stable and no delay
After antibiotics if unstable or delayed access
Key concepts
Neonatal fever framework
Immature immunity
Subtle early signs
Higher invasive bacterial infection risk than older infants
Common invasive pathogens
Escherichia coli
Group B Streptococcus
Listeria monocytogenes
Viral pathogens with high consequence
HSV risk highest in first weeks of life
Enterovirus consideration in season
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.