🚨 Sepsis Bundle (Hour-1)
UsePrompt the time-critical Hour-1 bundle for sepsis and septic shock at the bedside.
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SourcePrescott HC, et al. SSC 2026 Crit Care Med. doi:10.1097/CCM.0000000000007075
Runs locally in your browser (no PHI uploaded). For licensed clinicians — not a substitute for clinical judgement.
Stored on this device for revisit reminders
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
- Who it is for
- Adults with suspected infection when deciding whether to treat this hour as sepsis.
- Who it is not for
- Stable patients scored only to fill a number. Children do not follow adult bundle dosing.
- Formula and variables
- qSOFA is respiratory rate, systolic pressure, and mentation. NEWS2 is respiration, oxygenation, supplemental oxygen, blood pressure, pulse, consciousness, and temperature. SOFA is six organ systems. MEWS stays off the main door. Weights stay as on this page. qSOFA is not a diagnosis.
- Result → next step
- A positive screen only escalates assessment. Next page is the sepsis bundle. qSOFA alone must not switch on antibiotics. Antimicrobials stay at drug-class direction; the spectrum page may be opened. No numeric dose here.Spectrum (class) →
- Guideline and review date
- SSC 2026 (2026-03-23)
Score + version; reference only — not a substitute for care · no HIS write
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Methodology · worked example, guidelines & full notes
Clinical takeaway
Antibiotics within 1 h for septic shock or high suspicion; aim within 3 h for possible sepsis without shock.
When to use
Prompt the time-critical Hour-1 bundle for sepsis and septic shock at the bedside.
How it works
Three fixed items always apply (measure lactate, blood cultures, early broad-spectrum antibiotics). ≥ 30 mL/kg crystalloid in the first 3 h (population [Pending update]); persistent hypotension → norepinephrine to MAP ≥ 65. Source: SSC 2026 (recommendations 10, 13, 16–18, 53).
Key points
- Antibiotics within 1 h for septic shock or high suspicion; aim within 3 h for possible sepsis without shock.
- Norepinephrine is first-line; peripheral initiation [Pending update].
- Fluid type and weight basis [Pending update]; reassess volume responsiveness dynamically rather than repeating fixed boluses.
- Lactate recheck [Pending update]; control the source and de-escalate by susceptibility.
References
- [Original paper / primary source]Prescott HC, et al. SSC 2026 Crit Care Med. doi:10.1097/CCM.0000000000007075
- [Guideline basis]Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Med. 2026;54(4):725-812. doi:10.1097/CCM.0000000000007075 — SSC 2026 (2026-03-23).
- [Guideline basis]Prescott HC, et al. Executive Summary: Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026. Crit Care Med. 2026;54(4):715-724. doi:10.1097/CCM.0000000000007089.
- [Guideline basis]SSC 2026 ICM parallel doi:10.1007/s00134-026-08361-1
- [Guideline basis]Prescott HC, Antonelli M, Alhazzani W, et al. Surviving Sepsis Campaign: international guidelines for management of sepsis and septic shock 2026. Intensive Care Med. 2026;52(5):863-936. doi:10.1007/s00134-026-08361-1 — SSC 2026 ICM parallel.
- [Guideline basis]Evans L, Rhodes A, Alhazzani W, et al. Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021. Crit Care Med. 2021;49(11):e1063-e1143. doi:10.1097/CCM.0000000000005337 — SSC 2021 (historical).
- [Guideline basis]Evans L, et al. Surviving sepsis campaign: international guidelines for management of sepsis and septic shock 2021. Intensive Care Med. 2021;47(11):1181-1247. doi:10.1007/s00134-021-06506-y — SSC 2021 ICM parallel (historical).
- [Guideline basis]Levy MM, Evans LE, Rhodes A. The Surviving Sepsis Campaign Bundle: 2018 Update. Crit Care Med. 2018;46(6):997-1000. doi:10.1097/CCM.0000000000003119 — Hour-1 Bundle update (historical framing for this bedside checklist).
- [Guideline basis]SCCM Surviving Sepsis Campaign
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Blood lactate | 3.2 mmol/L |
|---|---|
| Hypotension/shock (MAP < 65 or needs vasopressor) | Yes |
→ActionSeptic shock/hypoperfusion: start Hour-1 bundle
- Three fixed items：① Measure lactate immediately; ② obtain blood cultures (timing [Pending update]); ③ early empiric broad-spectrum antibiotics (within 1 hour for septic shock/high suspicion; aim within 3 hours for possible sepsis without shock)
- Fluid resuscitation：Fluids: at least 30 mL/kg crystalloid in the first 3 hours (population, fluid type and weight basis [Pending update])
- Vasopressor target：Persistent hypotension during/after fluids: norepinephrine first-line, maintain MAP ≥ 65 mmHg
| Blood lactate | 3.2 mmol/L |
|---|---|
| Hypotension/shock (MAP < 65 or needs vasopressor) | No |
→ActionSepsis: start Hour-1 bundle
- Three fixed items：① Measure lactate immediately; ② obtain blood cultures (timing [Pending update]); ③ early empiric broad-spectrum antibiotics (within 1 hour for septic shock/high suspicion; aim within 3 hours for possible sepsis without shock)
- Fluid resuscitation：Fluids: at least 30 mL/kg crystalloid in the first 3 hours (population, fluid type and weight basis [Pending update])
- Vasopressor target：No vasopressor needed yet (start if hypotension develops)
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Sepsis Bundle (Hour-1)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Sepsis Bundle (Hour-1) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Sepsis Bundle (Hour-1) calculated in practice? Can you show a worked example?
- Inputs: Blood lactate 3.2 mmol/L, Hypotension/shock (MAP < 65 or needs vasopressor) Yes → Result: Action Septic shock/hypoperfusion: start Hour-1 bundle（Three fixed items: ① Measure lactate immediately; ② obtain blood cultures (timing [Pending update]); ③ early empiric broad-spectrum antibiotics (within 1 hour for septic shock/high suspicion; aim within 3 hours for possible sepsis without shock), Fluid resuscitation: Fluids: at least 30 mL/kg crystalloid in the first 3 hours (population, fluid type and weight basis [Pending update]), Vasopressor target: Persistent hypotension during/after fluids: norepinephrine first-line, maintain MAP ≥ 65 mmHg） Inputs: Blood lactate 3.2 mmol/L, Hypotension/shock (MAP < 65 or needs vasopressor) No → Result: Action Sepsis: start Hour-1 bundle（Three fixed items: ① Measure lactate immediately; ② obtain blood cultures (timing [Pending update]); ③ early empiric broad-spectrum antibiotics (within 1 hour for septic shock/high suspicion; aim within 3 hours for possible sepsis without shock), Fluid resuscitation: Fluids: at least 30 mL/kg crystalloid in the first 3 hours (population, fluid type and weight basis [Pending update]), Vasopressor target: No vasopressor needed yet (start if hypotension develops)）