qSOFA Sepsis Screen
Three bedside flags to sepsis risk and action.
What it does
Sepsis kills by hiding behind ordinary vitals until organs fail. qSOFA compresses three bedside checks into a score that flags high-risk infected patients in seconds, no labs required. Two or more means move now.
The tool above takes breathing rate, systolic pressure, and mentation as yes-or-no flags and prints score with band and action. Low risk watches and rescores; high risk triggers cultures, lactate, fluids, and antibiotics.
Sepsis Alliance education with CDC clinical resources teach these same bedside criteria behind early recognition. Full SOFA grading follows with labs; qSOFA starts the clock that labs cannot afford to delay.
Sort fast, work up fully, rescore often. A 1 turning 2 at handoff escalates care before deltas declare themselves. Antibiotics within the hour save the lives that scores merely predict.
How to use
- Mark fast breathing yes or no.
- Mark low systolic yes or no.
- Mark altered mentation yes or no.
- Read score, band, and action.
- Work up high scores at once.
- Rescore on change and handoff.
Formula
- RR
- Breathing 22/min or faster.
- SBP
- Systolic 100 mmHg or less.
- GCS
- Glasgow Coma Scale under 15.
Cutoffs: respiratory rate at or above 22, systolic at or below 100, Glasgow below 15. Two or more means high risk. Outside-ICU screening only; ICU patients use SOFA.
Worked example
Example: 3 of 3, high risk
Infected patient meeting all three qSOFA checks.
- Breathing 24/min or faster: yes.
- Systolic 100 or less: yes.
- GCS under 15: yes.
- Score totals 3 pts: High risk.
- Sepsis workup now per protocol.
Reference table
| Score | Band | Move |
|---|---|---|
| 0 | Low | Routine monitoring |
| 1 | Low | Watch, rescore often |
| 2 | High | Sepsis workup now |
| 3 | High | Full protocol now |
Limits
- Screening only. Cultures and judgment diagnose.
- Outside-ICU tool; ICU uses SOFA.
- Misses some sepsis at low scores.
- One snapshot; trends decide.
Common mistakes
- Waiting on labs before acting.
- Ignoring a rising 1.
- Scoring without infection context.
- Skipping lactate with high scores.
- Forgetting handoff rescores.
Try it yourself
Quick checks. Answers sit tucked under each question.
Only fast breathing present?
One flag scores 1 pt: Low risk. Routine monitoring, rescore on change.
Fast breathing plus low pressure?
Two flags score 2 pts: High risk. Sepsis workup now.
Questions
What are the three qSOFA checks?
Breathing rate 22 or more, systolic pressure 100 or less, and Glasgow under 15, one point each. Two or more flags high risk of poor outcome outside the ICU.
qSOFA vs SOFA: what differs?
Bedside speed without labs: qSOFA sorts in seconds while SOFA needs bilirubin, platelets, and pressor data. High qSOFA triggers the full workup that SOFA then grades.
Does low mean no sepsis?
No. Low scores miss some sepsis, and high scores flag other crises. It sorts urgency; cultures, lactate, and judgment diagnose.
What does the workup include?
Cultures first, then broad antibiotics fast, lactate, fluids, and source control. Every hour of antibiotic delay raises mortality in septic shock.
Who breaks the rules?
Age, frailty, immune suppression, and pregnancy shift concern at any score. Young healthy adults compensate longer; elders crash sooner.
How often should I rescore?
On change and at handoffs: vitals drift fast in sepsis. A 1 becoming a 2 escalates care before labs return.