Emergency Medicine

Recognising sepsis early: beyond the old SIRS criteria

Sepsis is organ dysfunction caused by a dysregulated response to infection. Spotting it early still depends on clinical vigilance.

Published:Aug 29, 2026
TypePerspective
Read Time1 min read

Sepsis kills millions of people every year, and many deaths follow a delay in recognition. The modern definition focuses on organ dysfunction rather than inflammation alone.

What changed with Sepsis-3

The 2016 Sepsis-3 consensus defined sepsis as life-threatening organ dysfunction caused by a dysregulated host response to infection, identified by an acute rise of two or more points in the SOFA score. Septic shock is sepsis with vasopressor requirement and a raised lactate despite adequate fluid resuscitation.

Screening tools have limits

The quick SOFA score — respiratory rate of 22 or more, altered mentation and systolic blood pressure of 100 mmHg or less — predicts poor outcome, but it is not sensitive enough to be used alone as a screening tool. Early warning scores and clinical judgement remain essential.

Early priorities:

  • Measure lactate and take blood cultures
  • Give antimicrobials promptly — within one hour when shock is likely
  • Start fluid resuscitation for hypotension or high lactate
  • Find and control the source of infection
“Ask ‘could this be sepsis?’ every time a patient with infection looks unwell.”

Imaging plays a growing role in source identification — from chest radiographs to ultrasound for biliary and renal sources and CT for intra-abdominal collections.

This article is for education only and does not replace clinical judgement or local guidelines.