Table 2. Hour-1 surviving sepsis campaign bundle of care.

The five key elements of hour-1 bundle
1. Measure lactate level. Remeasure if initial lactate is >2 mmol/L.
2. Obtain blood cultures prior to administration of antibiotics.
3. Administer broad-spectrum antibiotics.
4. Begin rapid administration of 30 mL/kg crystalloid for hypotension or lactate ≥4 mmol/L.
5. Apply vasopressors if patient is hypotensive during or after fluid resuscitation to maintain MAP ≥65 mm Hg.

“Time zero” or “time of presentation” is defined as the time of triage in the Emergency Department, or if presenting from another care venue, from the earliest chart annotation consistent with all elements of sepsis (formerly severe sepsis) or septic shock ascertained through chart review.

Adapted from Levy et al. Crit Care Med. 2018;46:997-1000, with permission of Society of Critical Care Medicine61.

MAP: mean arterial pressure.