SSC Hour-1 Bundle

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.

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. As explained in the article linked below, more than one hour may be required for resuscitation to be completed, but the Campaign encourages the 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.


Surviving Sepsis Campaign: Guidance on the Guidelines and Bundle
Surviving Sepsis Campaign:
Guidance on the Guidelines
and Bundle
The Surviving Sepsis Campaign Bundle: 2018 update
Surviving Sepsis Campaign
Bundle: 2018 update

Print SCC Hour-1 Pocket Card

The Surviving Sepsis Campaign Bundle: 2018 Update

Critical Care Medicine
Intensive Care Medicine

Hour-1 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.

"Time zero" or "time of presentation" is defined as the time of triage in the emergency department or, if presenting from another care venue, from the earliest chart annotation consistent with all elements of sepsis (formerly severe sepsis) or septic shock ascertained through chart review.

Bundle Implementation

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. ​Enhancing reliability of the Hour-1 bundle allows teams to focus on aspects of the changes they are implementing. The aim is to create a reliable system that reduces the odds for both death and morbidity from sepsis.

Find more bundle implementation​​ resources.​​​​​​​​