Patient handout

Sepsis bridge (recognition + Hour-1 bundle)

PRODUCTION

1. Your condition

This handout is for sepsis bridge (recognition + hour-1 bundle). Your care team identified this based on: fever + suspected source (cough, dysuria, abdominal pain, skin).

Other reasons your team may use this plan: acute ams (especially elderly — atypical sepsis presentation); sbp <90 or map <65; unexplained lactate >2 mmol/l.

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

qSOFA ≥2 (any 2 of: RR ≥22, AMS, SBP ≤100) (Sepsis-3 Singer JAMA 2016)
Lactate >4 mmol/L OR persistent lactate >2 with hypotension (SSC 2026)(life-threatening)
Vasopressor required after adequate fluid + lactate >2 (Sepsis-3 Singer JAMA 2016)(life-threatening)
MAP <65 despite norepi >0.5 mcg/kg/min + vasopressin + hydrocortisone (SSC 2021)(life-threatening)
Fever (>38 C) + ANC <500 (or <1000 expected to fall <500) (IDSA 2010)(life-threatening)
Pregnancy + sepsis (any severity) (SSC 2021)
Acute AMS in elderly without other obvious cause (SSC 2021)

5. Follow-up

Post-sepsis 2-week visit (post-sepsis syndrome / PICS screening); AKI 3-month recovery check; PCP med reconciliation; ID specialist if complex/resistant

6. Sources

Guideline: Surviving Sepsis Campaign 2026 Adult Guidelines + Sepsis-3 (Singer JAMA 2016) + SEPSISPAM (Asfar NEJM 2014) + OVATION-65 (Lamontagne JAMA 2020) + ANDROMEDA-SHOCK (Hernández JAMA 2019) + CLOVERS (Shapiro NEJM 2023) + SMART/BaSICS/PLUS balanced-crystalloid trials + 2025 ATS CAP + KDIGO 2026 AKI + APROCCHSS (Annane NEJM 2018) + ADRENAL (Venkatesh NEJM 2018) + VASST (Russell NEJM 2008) + Phoenix 2024 peds criteria (Sanchez-Pinto JAMA 2024) routed to id.sepsis.peds.v1