Another update on the Surviving Sepsis Campaign. Stemming from experts’ concerns about excessive fluid administration and rushing the diagnosis, the update acknowledges more time may be needed to establish a definitive diagnosis, while still stressing the urgency of sepsis treatment. And it also advises vasopressors may be started concurrently with fluid for hypotension:
Surviving Sepsis Campaign Hour-1 Bundle of Care Elements:
- Measure lactate level*
- Obtain blood cultures before administering antibiotics.
- Administer broad-spectrum antibiotics.
- Begin rapid administration of 30mL/kg crystalloid for hypotension or lactate level ≥ 4 mmol/L.
- Apply vasopressors if hypotensive during or after fluid resuscitation to maintain MAP ≥ 65 mm Hg.
* Remeasure lactate if initial lactate is elevated (> 2 mmol/L).