🚨 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.
Clinical takeaway
Antibiotics within 1 h for septic shock or high suspicion; aim within 3 h for possible sepsis without shock.
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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 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.
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 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.
References
Decision support for licensed clinicians only; not a substitute for clinical judgement, diagnosis or local protocols.
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)
Frequently asked 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)）