Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026

Front

1 of 3 · Front

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2026

In one breath

The 2026 Surviving Sepsis Campaign guideline for adults with sepsis or septic shock: NEWS/NEWS2, MEWS or SIRS rather than qSOFA alone for hospital screening, early cultures and lactate, at least 30 mL/kg crystalloid in the first 3 hours for hypoperfusion — calculated thoughtfully, with frequent reassessment.

Edition2026

Issued bySCCM and ESICM (international joint guideline)

Place of issueInternational

⏳ Pending verification

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 1

2 of 3 · Back 1

Back colours mark the reading sections — the chapter colour is the band and chip.

§1 · What it covers

This guideline covers updated adult sepsis/septic shock management, including hospital, immediate prehospital, and immediate post-hospital care; antimicrobial stewardship, diagnostics, resuscitation, source control, ICU support, rehabilitation, transitions, and goals of care.

Applies to: Adults with possible, probable, or definite sepsis/septic shock, including acutely ill adults before hospital arrival and after discharge.

§2 · Key recommendations

Use NEWS/NEWS2, MEWS, or SIRS rather than qSOFA as a single hospital screening tool.
collect blood cultures as soon as possible and ideally before antimicrobials.
measure lactate.
begin treatment immediately.
suggest at least 30 mL/kg IV crystalloid in the first three hours for sepsis-induced hypoperfusion/septic shock but calculate weight thoughtfully and reassess frequently.
consider immediate concurrent peripheral vasopressors in unstable shock rather than delaying for central access.
use performance-improvement programs and sepsis huddles.
preserve antimicrobial stewardship through diagnostic precision and de-escalation.
integrate source control, organ support, rehabilitation, discharge, and time-limited trials/goals of care.

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

Back 2

3 of 3 · Back 2

Back colours mark the reading sections — the chapter colour is the band and chip.

§3 · Evidence & grading

129 statements, including 46 new statements. The page labels recommendations as strong, conditional, or good-practice statements and gives certainty (moderate, low, very low for the displayed recommendations). Examples: strong/moderate for NEWS/NEWS2/MEWS/SIRS over qSOFA; strong/low for early blood cultures; conditional/low for lactate; conditional/low for at least 30 mL/kg; conditional/very-low for peripheral vasopressors in appropriate patients; strong/moderate for hospital performance-improvement programs, with very-low certainty for standard operating procedures.

§4 · What changed in this edition

Compared with the previous edition (2021), the 2026 guideline retains at least 30 mL/kg crystalloid only as a suggestion with stronger emphasis on individual characteristics and repeated reassessment, and prefers NEWS/NEWS2, MEWS or SIRS over qSOFA as a single hospital screening tool (per this record's own evidence note). A recommendation-by-recommendation change table: Not yet established — pending verification (full-text pass).

§5 · Source & working link

Surviving Sepsis Campaign (SCCM/ESICM). International Guidelines for Management of Sepsis and Septic Shock 2026. SCCM guideline page, 2026. DOI/PMID: Not yet established — pending verification.

Publisher — the record's original_url, carried verbatim ↗

Link check 2026-11-11: the publisher (SCCM) URL fetched live — HTTP 200. The record carries no DOI/PMID and none was established from a named source at build time — Not yet established — pending verification.

Source: Tamer-supplied guideline index, intake 2026-11-10 (record #150, Domain 14) · Card built 2026-11-11 (Wave D) from the record itself; the §5.2 verification pass (UpToDate + Medscape → Perplexity → Tamer decision) has not yet run on this card. ⚑ Conflict flag on the source record — documented cross-society disagreement (intake DOCX Table 2): Sepsis — SSC 2021 vs SSC 2026. This record's own evidence note states the point: 2026 softens the apparent universality of the 2021 30 mL/kg rule by emphasizing context and ongoing reassessment, and prefers NEWS-family tools, MEWS or SIRS over qSOFA-centred screening. Unresolved — pending the verification pass (UpToDate + Medscape → Perplexity → Tamer decision).

FACE COLOURS Front — the summary · Back 1 — what it covers + key recommendations · Back 2 — evidence, changes + source

gl-div06-ssc-sepsis-2026GS.code · Guidelines

More in Division 6 · Emergency, Trauma, Acute Care & Surgical Critical Care

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care⏳ Pending verification

Diagnosis and Treatment of Acute Appendicitis: 2025 Edition of the World Society of Emergency Surgery Jerusalem Guidelines

The 2025 Jerusalem update for acute appendicitis: 35 GRADE recommendations over 19 questions — risk scores and imaging first, antibiotics alone only for selected uncomplicated cases, laparoscopic appendectomy as the standard operation, and 2–3 days of postoperative antibiotics in complicated disease.

2025 Edition · World Society of Emergency Surgery (WSES)

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care⏳ Pending verification

Guideline for the Diagnosis and Treatment of Appendicitis

SAGES' guideline for the diagnosis and treatment of appendicitis: imaging first, operative management suggested for both uncomplicated and complicated adult disease, flexible timing, and interval appendectomy after successful nonoperative treatment of complicated disease.

2023 · Society of American Gastrointestinal and Endoscopic Surgeons (SAGES)

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care⏳ Pending verification

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021

The 2021 Surviving Sepsis Campaign guideline for adults with sepsis or septic shock: immediate resuscitation, early antimicrobials and source control, an initial MAP target of 65 mmHg on vasopressors, and norepinephrine as the first-line vasopressor.

2021 · Surviving Sepsis Campaign — Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM)

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care⏳ Pending verification

The European guideline on management of major bleeding and coagulopathy following trauma: sixth edition, 2023

The sixth European guideline on major bleeding and coagulopathy after trauma: early repeated haemostasis monitoring, tranexamic acid as soon as possible and within 3 hours (1 g over 10 minutes, then 1 g over 8 hours), and rapid haemorrhage control.

Sixth Edition, 2023 · Multidisciplinary European Task Force (ESAIC, ESICM, European Shock Society, ESTES, EuSEM and NATA)

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care⏳ Pending verification

Joint Trauma System Damage Control Resuscitation Clinical Practice Guideline, 2019 with June/August 2023 updates

The Joint Trauma System damage-control resuscitation CPG for massively haemorrhaging combat casualties: haemorrhage control first, whole blood or balanced components over crystalloid, early calcium, and — since the June 2023 update — a 2-g tranexamic acid bolus as close to injury as possible.

2019, with June/August 2023 updates · Joint Trauma System, Defense Health Agency / US military

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care⚪ Superseded by Surviving Sepsis Campaign 2026 edition

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock 2021

The 2021 Surviving Sepsis Campaign guideline (Domain 14 filing) — superseded by the 2026 edition per this record: immediate treatment, cultures before antimicrobials where feasible, an initial 30 mL/kg crystalloid for hypoperfusion with reassessment, and norepinephrine first-line.

2021 · Society of Critical Care Medicine (SCCM) and European Society of Intensive Care Medicine (ESICM)

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care⏳ Pending verification

ESPEN practical and partially revised guideline: Clinical nutrition in the intensive care unit

ESPEN's practical ICU nutrition guideline: assess nutritional risk, prefer early oral or enteral feeding when feasible, individualise parenteral nutrition, use indirect calorimetry where available, and approach energy and protein targets progressively rather than forcing full targets early.

2023 (practical, partially revised) · European Society for Clinical Nutrition and Metabolism (ESPEN)

📘 GuidelineCh 6 · Emergency, Trauma, Acute Care & Surgical Critical Care⏳ Pending verification

Guidelines for the provision of nutrition support therapy in the adult critically ill patient: The American Society for Parenteral and Enteral Nutrition

ASPEN's 2022 nutrition support guideline for the adult critically ill patient: because no consistent outcome differences were found, prescribe energy cautiously at 12–25 kcal/kg/day, favour enteral nutrition when feasible, and assume no advantage for exclusive or supplemental parenteral nutrition or higher doses.

2022 · American Society for Parenteral and Enteral Nutrition (ASPEN)