qSOFA
Quick Sepsis Bedside Screen
2 of 3 → think sepsis, escalate care immediately.
What this mnemonic does is collapse a complex sepsis definition into three bedside vital signs that any NP can collect in two minutes. qSOFA scores one point each for respiratory rate 22 or higher, altered mental status (GCS under 15), and systolic blood pressure 100 or lower. Two or more positive criteria identifies patients at higher risk of in-hospital mortality and triggers fuller sepsis workup — lactate, blood cultures, and broad-spectrum antibiotics within an hour if confirmed. AANP exam vignettes use qSOFA to test escalation: a confused patient with tachypnea and borderline pressure does not get sent home, even if temp is normal and the WBC has not returned.
- 1Respiratory rate ≥22Tachypnea is an early, sensitive sepsis sign.
- 2Altered mentationGCS <15 or any new confusion.
- 3Systolic BP ≤100Hypotension — even borderline numbers count.
Clinical Context
Bedside sepsis screen using three simple criteria. ≥2 positive suggests high risk of sepsis-related mortality and triggers immediate sepsis workup: lactate, blood cultures × 2, and broad-spectrum antibiotics within 1 hour. Replaced SIRS as the 2016 Sepsis-3 consensus preferred bedside tool.
Don't use qSOFA for diagnosis — it's a screen. Definitive criteria require the full SOFA score plus documented infection. Practical framing: qSOFA answers "should I be worried?" If yes, activate the sepsis protocol and calculate full SOFA later. AANP sepsis questions expect both qSOFA (bedside) and SOFA (definitive) knowledge.
Related Mnemonics
- TORCH — Congenital Infections (Vertical Transmission)
Sources
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