SSC Hour-1 Bundle

The Surviving Sepsis Campaign (SSC) Bundle is the core of the sepsis improvement efforts. Using the hour-1 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.


Print SSC Hour-1 Bundle Infograph
Print SCC Hour-1 Pocket Card

The Surviving Sepsis Campaign Bundle: 2018 Update
Hour-1 Surviving Sepsis Campaign Bundle of Care

• Measure lactate level. Remeasure if initial lactate is >2 mmol/L.
• Obtain blood cultures prior to administration of antibiotics.
• Administer broad-spectrum antibiotics.
• Begin rapid administration of 30ml/kg crystalloid for hypotension or lactate ≥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, but it must meet the standards created by the hour-1 bundle. 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.