In septic shock, which component of the Surviving Sepsis Campaign (SSC) Hour-1 Bundle (2018) must be completed FIRST before administering antibiotics?

• A Administer norepinephrine to achieve MAP > 65 mmHg
• B Begin 30 mL/kg crystalloid resuscitation
• C Measure lactate level
• D Obtain blood cultures (at least 2 sets) ✓

Explanation

The SSC Hour-1 Bundle mandates that blood cultures (minimum 2 sets — aerobic and anaerobic) be obtained BEFORE antibiotic administration to maximise the diagnostic yield of blood culture. The other bundle elements (lactate measurement, 30 mL/kg crystalloid, broad-spectrum antibiotics, vasopressors if MAP < 65 mmHg) can be initiated concurrently or in sequence, but antibiotics must not precede blood cultures. Every hour delay in antibiotic administration increases mortality, making timely cultures and prompt antibiotics both critical.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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