Sepsis criteria question

In reading sepsis 2 criteria, it is noted that we need an infection plus 2 or more of the following criteria (RR,Temp, WBC, HR) I have heard from couple sources that it is not enough that you have 2 of these criteria unless we see several readings consecutively so (2 RR, 2 Temperature, etc.) I do not see this requirement written (stated)anywhere except in denials.

I also have read that with initial treatment for sepsis those vitals can change quickly, so in this case how would we have multiple vital readings?

I have to believe this is just another tactic for payers to deny by twisting meanings.

This question is specific to the vitals as I do realize we need much more once have infection and 2 or more. Do we need more than one reading for a (RR, Temp, WBC, HR) to count as a criteria?

Thank you,



  • I look for a trend (can be descriptive vs recorded number). A single number would be of concern for inaccurate reading. Physical exam would be one area helpful for the descriptive back up.

    I also consider whether there is another likely cause -- such as afib for tachy.

    Finally, I really like to have more than just the SIRs criteria (vitals, wbc) to support sepsis; though not necessarily Sepsis 3 criteria.

    We follow the lead of our clinicians who did have formal conversations centered on sepsis 2 vs 3, and chose 2.

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