The critical care community has long been plagued by a series of antiquated, overbearing guidelines created by the Surviving Sepsis Campaign (SSC). The campaign was originally sponsored by Eli Lilly and Edwards Life Sciences, as a commercial marketing campaign.

The backbone of the original guidelines was a single center trial by Rivers, which has failed to be replicated.

Nonetheless, despite new evidence, the guidelines have been highly resistant to change, often causing them to lag several years behind modern sepsis care.

The Surviving Sepsis Campaign spawned the SEP-1 core measures for sepsis, an arcane set of goals which frequently pressures physicians to act against their best clinical judgement.

To make matters even worse, the 2018 SSC update doubled down on prior measures by mandating that fluids and antibiotics be administered within sixty minutes of emergency department triage.

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