Sepsis Bundle (Hour-1) — free guideline decision tool
Turn lactate and shock status into the Surviving Sepsis Campaign Hour-1 bundle: fixed items, fluid target and vasopressor goal. Instant, browser-side.
Open guideline tool →Guideline-based
Implements the decision logic from published clinical guidelines.
Runs in your browser
No installation. Enter the patient's values and get a guideline recommendation instantly.
Data stays local
Nothing is uploaded. Results are for licensed clinicians only.
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 before antibiotics; 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：Hypotension or lactate ≥ 4: give fluids rapidly, at least 30 mL/kg in the first 3 hours (balanced crystalloid preferred, by actual body weight; use adjusted weight if BMI > 30)
- Vasopressor target：Persistent hypotension during/after fluids: norepinephrine first-line, maintain MAP ≥ 65 mmHg (may start peripherally to avoid delay)
| 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 before antibiotics; 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：No hypotension and lactate < 4: give fluids as needed guided by dynamic measures, routine 30 mL/kg not required
- Vasopressor target：No vasopressor needed yet (start if hypotension develops)
Common questions
What is Sepsis Bundle (Hour-1)?
Turn lactate and shock status into the Surviving Sepsis Campaign Hour-1 bundle: fixed items, fluid target and vasopressor goal. Instant, browser-side.
How is Sepsis Bundle (Hour-1) calculated? What is the core formula?
Three fixed items always apply (measure lactate, blood cultures before antibiotics, early broad-spectrum antibiotics). Hypotension or lactate ≥ 4 → ≥ 30 mL/kg balanced crystalloid in the first 3 h; persistent hypotension → norepinephrine to MAP ≥ 65; recheck lactate at 2–4 h if > 2.
When is Sepsis Bundle (Hour-1) used?
Prompt the time-critical Hour-1 bundle for sepsis and septic shock at the bedside.
What are the key clinical points for Sepsis Bundle (Hour-1)?
Antibiotics within 1 h for septic shock or high suspicion; aim within 3 h for possible sepsis without shock. Norepinephrine is first-line and may be started peripherally to avoid delay while central access is obtained. Use balanced crystalloid by actual body weight (adjusted weight if BMI > 30); reassess volume responsiveness dynamically rather than repeating fixed boluses. Lactate clearance guides ongoing resuscitation; control the source and de-escalate by susceptibility.
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.
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 before antibiotics; 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: Hypotension or lactate ≥ 4: give fluids rapidly, at least 30 mL/kg in the first 3 hours (balanced crystalloid preferred, by actual body weight; use adjusted weight if BMI > 30), Vasopressor target: Persistent hypotension during/after fluids: norepinephrine first-line, maintain MAP ≥ 65 mmHg (may start peripherally to avoid delay)） 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 before antibiotics; 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: No hypotension and lactate < 4: give fluids as needed guided by dynamic measures, routine 30 mL/kg not required, Vasopressor target: No vasopressor needed yet (start if hypotension develops)）
Run Sepsis Bundle (Hour-1) now
Turn lactate and shock status into the Surviving Sepsis Campaign Hour-1 bundle: fixed items, fluid target and vasopressor goal. Instant, browser-side.
Open guideline tool →For licensed clinicians. Not a substitute for clinical judgement.
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