No SIRS; Quick SOFA Instead

SCCM Redefines Sepsis Without Emergency Medicine Input
      It’s barely noon and already 5 patients have triggered a sepsis alert in triage. Once that happens, patients are expedited into the emergency department (ED), assessed, and treated urgently. Laboratory tests are ordered; fluids are given. Two systemic inflammatory response criteria and suspect infection is all it takes to sound the alarm, but this may be about to change.
      To read this article in full you will need to make a payment
      ACEP Member Login
      ACEP Members, full access to the journal is a member benefit. Use your society credentials to access all journal content and features.
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Purchase one-time access:

      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Singer M.
        • Deutschman C.S.
        • Seymour C.W.
        • et al.
        The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).
        JAMA. 2016; 315: 801-810
        • Seymour C.W.
        • Liu V.X.
        • Iwashyna T.J.
        • et al.
        Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3).
        JAMA. 2016; 315: 762-774
        • Vincent J.L.
        Organ dysfunction in patients with severe sepsis.
        Surg Infect (Larchmt). 2006; 7: S69-S72
        • Levy M.M.
        • Fink M.P.
        • Marshall J.C.
        • et al.
        2001 SCCM/ESICM/ACCP/ATS/SIS International Sepsis Definitions Conference.
        Crit Care Med. 2003; 31: 1250-1256
        • Kaukonen K.M.
        • Bailey M.
        • Bellomo R.
        Systemic inflammatory response syndrome criteria for severe sepsis.
        N Engl J Med. 2015; 373: 881

      Linked Article

      • Sepsis-3 Definitions
        Annals of Emergency MedicineVol. 68Issue 6
        • Preview
          I am concerned that the recent “No SIRS: Quick SOFA Instead” column authored by Jeremy Faust and featured in the May News & Perspectives section is inaccurate. Specifically, the table labeled Figure 1 and titled “Sepsis Definitions” in row 2, column 3 seems to have simply substituted quick Sequential Organ Failure Assessment (qSOFA) and Sequential Organ Failure Assessment (SOFA) in place of systemic inflammatory response syndrome (SIRS) in the old definition, implying that Sepsis-3 defines sepsis as “suspected or documented infection + ≥2 of qSOFA or Rise in SOFA score ≥2 points.” As presented in the table, this definition is not contained in the published findings of the Sepsis-3 investigators.
        • Full-Text
        • PDF