A foundational discussion on evaluation and treatment of acute transfusion reactions. Adapted from a lecture by Dr. Scott.  

Diagram Credit: S Rezaie

Adapted from Abdulla Alhmoudi's GR presentation May, 2016.

The management of sickle cell pain crises can be difficult due to our inability to rely on vital signs to lead our management, as well as the need for maintaining a broad differential in a patient with sickle cell disease. 

qSOFA was introduced as part of the Sepsis-3 guidelines published in February 2016. SOFA is a well-known scoring system used in the ICU setting, and qSOFA is a simplified version that uses only 3 clinical criteria; altered mentation, tachypnea, and hypotension. 

Why the change; the current SIRS Criteria is less sensitive and specific than the SOFA score. Utilizing 2 or more SIRS criteria was felt to be unhelpful by the 2016 task force,

Instead, qSOFA utilizes the most important criteria for those at risk for poor outcomes from sepsis. 

Looking forward, remember that qSOFA is not a screening tool for sepsis, but a predictor of poor outcomes to help identify those patients who need additional providers and immediate interventions. 

To learn more about the new JAMA Third International Consensus Definitions for Sepsis and Septic Shock, read the article, or listen to the FOAMcast on Sepsis Redefined.