Start the hour-1 sepsis bundle

Practice the Surviving Sepsis hour-1 order from inpatient training. Antibiotics are not delayed for nonessential imaging once sepsis is recognized.

1. Recognize sepsis and note the time zero.
2. Measure lactate.
3. Obtain blood cultures before antibiotics if that does not delay the dose.
4. Give the broad-spectrum antibiotic.
5. Begin rapid 30 mL/kg crystalloid for hypotension or lactate ≥ 4 mmol/L.
6. Start vasopressors if the patient remains hypotensive during or after the fluid.
7. Target a mean arterial pressure of at least 65 mm Hg on vasopressors.
8. Remeasure lactate if the initial value is greater than 2 mmol/L.
9. Do not delay antibiotics for nonessential imaging.