Sepsis and pre-hospital care: where are we now?

Definitions:In February 2016, the International Consensus Definitions for Sepsis Task Force published recommendations for Sepsis-3. Major changes from earlier definitions included dropping the Systemic Inflammatory Response Syndrome (SIRS) criteria and introducing sequential Sepsis-related Organ Failure Assessment (SOFA) scoring. Sequential scoring will be impossible in some environments (including PH care), in which case the group recommends a quick-SOFA (qSOFA). qSOFA supports the diagnosis of sepsis in patients with suspected infection when two of the following criteria are present:A respiratory rate of 22 breaths per minute or greaterAltered mentationSystolic blood pressure of 100 mm Hg or less.This new sepsis definition has not been prospectively validated and its PH test characteristic is unknown. As such, NICE and the UKST are recommending the National Early Warning Score (NEWS) and the suspicion of infection as a trigger to screen for sepsis.

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