Septic Shock

Vasopressors + antibiotics + source control

First 30 seconds

  1. 1Sepsis Six (BUFALO) within 1 h
  2. 230 mL/kg crystalloid
  3. 3Blood cultures before antibiotics
  4. 4Antibiotics ≤1 h

Sepsis + persisting hypotension requiring vasopressors to maintain MAP ≥65 AND lactate >2 despite adequate fluid resuscitation.

A

Airway

  • Patent? Talking? Stridor?
  • Suction, jaw-thrust, adjuncts, definitive airway if needed
B

Breathing

  • RR, SpO₂, auscultate, percuss
  • O₂ to target sats, NIV / intubate as required
C

Circulation

  • HR, BP, cap refill, JVP
  • 2× large-bore IV, bloods, monitor, ECG
D

Disability

  • AVPU/GCS, pupils, glucose, temp
E

Exposure

  • Full exposure, skin, rash, bleeding, lines, infection source
View flowchart algorithm

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Clinical Decisions in Seconds