Finally, in the news for nurses this week, we take a look at the newly updated guidelines from the Society for Critical Care Medicine (SCCM) released at their 45th Critical Care Congress in Orlando recently. The guidelines throw out the use of the SIRS criteria (Systemic Inflammatory Response Syndrome) in favor of a more diagnostic Sequential Organ Failure Assessment criteria or SOFA.
Sepsis Assessment With SOFA Not SIRS
It was found that two or more of the SIRS criteria were present in many hospital situations and conditions resulting in many false sepsis alerts. The new criteria appear to be more diagnostic based on the newer research. It focuses on the impending cascade of organ failure resulting from sepsis in patients.
In the presence of a known or suspected infection, two or more of the SOFA criteria would indicate possible onset of septic shock. They include fluid unresponsive hypotension, elevated lactate levels, and need for vasopressors to maintain mean arterial pressures greater than 65.
Quick SOFA Assessment for Bedside
There is also a quick SOFA assessment that can be performed when immediate labs aren’t available. QSOFA criteria include respiratory rate greater than 22, altered mentation, and systolic blood pressure below 100 mm of mercury (Hg). Any two of these in the presence of suspected infection is a red flag to initiate sepsis protocols and get the lab work for a full SOFA assessment.
It is important to update these guidelines because Sepsis is one of the top killers of patients in the hospital setting around the world. It’s far more common than many people think and we all need to take a more proactive approach to managing our potentially septic patients more aggressively. I urge you, check out the full article I have linked in the show notes and read the full study results in the recent issue of JAMA.
Make sure you follow-up on the links for this news item and all of the other news and additional resource links from this week’s episode – Sepsis Assessment Updates for Nurses and Episode 386.