qSOFA Score for Sepsis
Quick bedside screen for sepsis-related organ dysfunction outside ICU
How to use & interpret
qSOFA is a rapid bedside prompt that flags patients with suspected infection who are at higher risk of poor outcomes (death or prolonged ICU stay). It scores one point each for respiratory rate ≥22, systolic BP ≤100 mmHg, and altered mentation (GCS <15).
A qSOFA ≥2 should prompt escalation, senior review and consideration of organ-dysfunction assessment, but it is a screening trigger, not a diagnosis of sepsis, and it is relatively insensitive for early sepsis. In UK practice NEWS2 is preferred for deterioration screening; qSOFA is best used to raise suspicion, not to rule sepsis out.
Score interpretation
qSOFA 0–1: Low risk of sepsis-related organ dysfunction
→ Standard clinical assessment; reassess if clinical concern remains
qSOFA ≥2: High risk of sepsis-related organ dysfunction (in-hospital mortality >10%)
→ Initiate Sepsis-6; IV access; blood cultures; IV antibiotics within 1 hour; lactate; fluid resuscitation
Interpretation bands for the qSOFA. Apply clinical judgement and local guidance.
Frequently asked questions
Is a qSOFA under 2 reassuring?
Not reliably — qSOFA misses many patients with early sepsis. Do not use it to exclude sepsis; combine clinical judgement with NEWS2 and lactate.
References
- Singer M, et al. The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3). JAMA. 2016;315(8):801–10.
Related
Curated clinical cross-links plus same-class fallbacks.
- Ceftriaxone (Paediatric) · Third-Generation Cephalosporin — Meningitis / Sepsis / Community-Acquired Pneumonia
- Gentamicin (Paediatric) · Aminoglycoside — Neonatal Sepsis / Gram-Negative Infections in Children
- Flucloxacillin (Burns — Wound Infection) · Antibiotic — Penicillinase-Resistant Penicillin
- Piperacillin-Tazobactam (Burns — Sepsis) · Antibiotic — Extended-Spectrum Penicillin + Beta-Lactamase Inhibitor
- Meropenem (Burns — Severe Sepsis/MDR) · Antibiotic — Carbapenem
- Colistin (Polymyxin E — XDR Burns Infection) · Antibiotic — Polymyxin (Last-Resort)
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Featured in these MRCEM clinical pathways
The qSOFA is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.