Sepsis Hour-1 Bundle

Surviving Sepsis Campaign hour-1 bundle for adult sepsis / septic shock.

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flowchart TD
ID[Suspected sepsis or septic shock] --> Lac[Measure lactate]
ID --> Cult[Blood cultures × 2\nbefore antibiotics]
ID --> Abx[Broad-spectrum antibiotics\nwithin 1 h]
ID --> Fluid{Hypotension or\nlactate ≥ 4?}
Fluid -- yes --> Crys[30 mL/kg crystalloid IV]
Crys --> Re{MAP &lt; 65 mmHg after fluid?}
Re -- yes --> Vaso["Start vasopressors<br/>(norepinephrine)"]
Re -- no --> Mon[Reassess + monitor]
Fluid -- no --> Mon
Vaso --> Mon
Lac --> Repeat[Repeat lactate if initial &gt; 2 mmol/L]