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Implement the Sepsis Resuscitation Bundle

Reducing mortality due to severe sepsis requires an organized process that guarantees early recognition and consistent application of the best evidence-based practices. The “Severe Sepsis Bundles” are a series of interventions that, when implemented together, will achieve significantly better outcomes than when implemented individually.

 

Hospitals should implement two different severe sepsis bundles.  Each bundle articulates requirements for specific timeframes.

 

  • Sepsis Resucitation Bundle: Evidence-based goals that must be completed within 6 hours for patients with severe sepsis, septic shock and/or lactate > 4 mmol/L (36 mg/dl).

 

  • Sepsis Management Bundle: Evidence-based goals that must be completed within 24 hours for patients with severe sepsis, septic shock and/or lactate > 4 mmol/L (36 mg/dl).

 

For patients with severe sepsis, as many as seven bundle elements must be accomplished within the first 6 hours of presentation.  Some items may not be completed if the clinical conditions described in the bundle do not prevail, but clinicians must assess for them.  The goal is to perform all indicated tasks 100 percent of the time within the first 6 hours of identification of severe sepsis.


Changes for Improvement
Serum Lactate Measured
Blood Cultures Obtained Prior to Antibiotic Administration
Improve Time to Broad-Spectrum Antibiotics
Treat Hypotension and/or Elevated Lactate with Fluids
Apply Vasopressors for Ongoing Hypotension
Maintain Adequate Central Venous Pressure
Maintain Adequate Central Venous Oxygen Saturation