Hi everyone! One of the most common diagnosis we see in our inpatient clinical practice is sepsis. Though the exact criteria to identify it may be a blurry line sometimes. Many patients trigger "sepsis alerts" on the floors without meeting clear cut criteria to actually trigger a sepsis bundle. The Sepsis/SIRS criteria are still used in many hospital protocols to identify those pt at risk for sepsis, even though the new qSOFA scale might be more closely associated with mortality. For example, a patient with history of A-fib and COPD comes to our ed complaning of cough. The pt baseline HR is around 105 and the RR around 21. Checking sirs/sepsis criteria this patient would trigger a sepsis alarm and bundle though those vital signs alterations might not be associated with any systemic response to infection. I understand clinical judgement plays a key role, but considering the importance of using preestablished power plans in clinical practice, My question would be: 1) what criteria do u use to identify sepsis? Sirs or qSOFA? should hospital sepsis protocols be triggered based on qsofa scores or SIRS criteria?
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