The Surviving Sepsis Campaign (SSC) Bundle is the core of the sepsis improvement efforts. Applying the sepsis bundle simplifies the complex processes of the care of patients with sepsis. The Surviving Sepsis Campaign Steering Committee and members of the Executive Committee collaborated to revise the bundle based on the 2016 guidelines recommendations. More information on the members of these committees can be found in the About SSC tab.
SCCM and ACEP Release Joint Statement About the SSC Hour-1 Bundle
The Society of Critical Care Medicine (SCCM) and the American College of Emergency Physicians (ACEP) acknowledge concerns expressed about the recently released Surviving Sepsis Campaign (SSC) Hour-1 bundle and the appropriateness of implementation in the United States. Both organizations understand the importance of prompt and optimal sepsis diagnostics and treatment. SCCM and ACEP along with other involved international experts are organizing a meeting as soon as possible to carefully review the recommendations, and provide guidance on bundle implementation and care of potentially septic patients who present to emergency departments in the United States. We recommend that hospitals not implement the Hour-1 bundle in its present form in the United States at this time.
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Hour-1 Bundle Overview
The guidelines and the bundle integrate identified decision points and courses of action that when combined with clinical judgment, can make a difference in patient outcomes. Note that the updated bundle is not mandated but rather serves as a guide and should be implemented within the first hour of sepsis recognition.
As explained in the article linked below, more than one hour may be required for resuscitation to be completed, but the Campaign encourages the prompt initiation of resuscitation and treatment, such as obtaining blood for measuring lactate and blood cultures, administration of fluids and antibiotics, and in the case of life-threatening hypotension, initiation of vasopressor therapy treating sepsis as a medical emergency.
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The Surviving Sepsis Campaign Bundle: 2018 Update
Critical Care Medicine
Intensive Care Medicine
Surviving Sepsis Campaign Bundle of Care
- Measure lactate level. Remeasure if initial lactate level > 2 mmol/L.
- 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 patient is hypotensive during or after fluid resuscitation to maintain MAP ≥ 65 mm Hg.
A bundle is a selected set of elements of care that, when implemented as a group, have an effect on outcomes beyond implementing the individual elements alone. Each hospital's sepsis protocol may be customized with the bundle serving as guidance when acknowledging that sepsis is a medical emergency. Each hospital's sepsis protocol may be customized with the bundle serving as guidance when acknowledging that sepsis is a medical emergency.
Find more bundle implementation resources.