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Alerts and Alarms-Can Electronic Medical Records Help Children and Adolescents Survive Sepsis?

Ben Driver1, Franz E Babl1,2,3,4, Daryl Cheng1,2,5,6

  • 1Murdoch Children's Research Institute, Parkville, Australia.

Journal of Paediatrics and Child Health
|May 2, 2026
PubMed

Insights

Automated sepsis alerts in electronic medical records may speed up treatment for children with sepsis. However, their impact on survival and other key outcomes requires further investigation with more studies.

Area of Science:

  • Pediatric critical care medicine
  • Health informatics
  • Clinical decision support systems

Background:

  • Early recognition and treatment of pediatric sepsis are crucial for improving survival rates.
  • Automated sepsis alerts in electronic medical records (EMRs) aim to identify high-risk children in real-time, potentially improving sepsis care timeliness.
  • Concerns exist regarding overdiagnosis, overtreatment, and alert fatigue associated with automated alerts.

Purpose of the Study:

  • To systematically review and synthesize evidence on the clinical outcomes of implementing EMR-based automated sepsis alerts in pediatric patients (<18 years).
  • To evaluate the impact of these alerts on mortality, PICU admission rates, length of stay, time to fluids/antibiotics, and antibiotic usage.

Main Methods:

  • A systematic review and narrative synthesis of twelve studies evaluating EMR-based automated sepsis alerts in pediatric patients.
  • Analysis focused on clinical outcomes, process measures (e.g., time to antibiotics/fluids), and balancing measures (e.g., hospital admission rates, antibiotic use).

Main Results:

  • Automated alerts were associated with improved process measures, including reduced time to antibiotics (4/6 studies) and fluids (2/5 studies).
  • One study reported reduced mortality in PICU patients (29.9% vs. 17.4%, p=0.011), with a trend towards fewer PICU admissions.
  • No significant impact on hospital or PICU length of stay was observed, and alerts did not increase hospital admission rates or antibiotic usage.

Conclusions:

  • Automated sepsis alerts show potential in improving the timeliness of fluid and antibiotic administration for pediatric sepsis.
  • While not increasing hospital admissions or antibiotic use, the overall impact on clinical outcomes, especially mortality, remains uncertain.
  • High-quality randomized controlled trials are necessary to definitively establish the role of automated sepsis alerts in improving pediatric sepsis outcomes.

Keywords:
alertchildrenelectronic medical recordpaediatricsepsis

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