Adult Patients

Surviving Sepsis Campaign 2021 Adult Guidelines
The new "Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021" provides guidance for the clinician caring for adult patients with sepsis or septic shock.

Critical Care Medicine | Intensive Care Medicine

Related Resources

Antibiotic Timing Infographic

Vasoactive Agent Management Infographic
Executive Summary
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Portuguese Translation: Surviving Sepsis Campaign 2021 Guidelines​

SSC Adult Guidelines 2021: What's New and What's Changed?

Brief Guideline Updates

Find brief guideline updates from heads of the guidelines writing groups. View all updates.

Infection Overview


Screening & Early Treatment


The hour-1 bundle should be viewed as a quality improvement opportunity moving toward an ideal state. For critically ill patients with sepsis or septic shock, time is of the essence. Although the starting time for the Hour-1 bundle is recognition of sepsis, both sepsis and septic shock should be viewed as medical emergencies requiring rapid diagnosis and immediate intervention. ​ ​

The hour-1 bundle encourages clinicians to act as quickly as possible to obtain blood cultures, administer broad spectrum antibiotics, start appropriate fluid resuscitation, measure lactate, and begin vasopressors if clinically indicated. Ideally these interventions would all begin in the first hour from sepsis recognition but may not necessarily be completed in the first hour. Minimizing the time to treatment acknowledges the urgency that exists for patients with sepsis and septic shock. ​

*Note that the description of the hour-1 bundle above is the most current description, having passed all approval points effective October 10, 2019.

Hour-1 Bundle Pocket Card and Infographic​​ (see more resources below)

How does the SSC update the bundle? 

Surviving Sepsis Campaign Hour-1 Bundle Teaching Slides

SSC 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).