一位護理師正在接收入院一位診斷為敗血症的病人。在識別後的第一小時內應啟動哪些介入措施？
A nurse is admitting a client diagnosed with sepsis. Which intervention should be initiated within the first hour of recognition?
- AAdminister intravenous fluids.給予靜脈輸液
- BObtain blood cultures.抽取血液培養
- CAdminister broad-spectrum antibiotics.✓ 正解給予廣效型抗生素
- DMeasure serum lactate level.測量血清乳酸濃度
敗血症（sepsis）的「第一小時 bundle」（Surviving Sepsis Campaign Hour-1 Bundle）包含五項介入：① 測量乳酸 ② 抽血培養 ③ 廣效抗生素 ④ 30 mL/kg 結晶體輸液（若低血壓或乳酸≥4） ⑤ 升壓劑（若液體無效時）。 本題若需排序「最關鍵」介入，答案為 C 廣效抗生素 — 每延遲 1 小時，敗血症死亡率上升 7-8%。理想流程：抽血培養（B）→ 立即給廣效抗生素（C）→ 同時給輸液（A）與測 lactate（D）。但若必須單選一項作為「核心救命行動」，廣效抗生素的時效性與直接死亡率關聯最強。 選項 B、A、D 也都是 1-hour bundle 的一環，只是優先順序上抗生素最直接影響存活率。
The Surviving Sepsis Campaign Hour-1 Bundle includes five interventions: (1) measure lactate, (2) obtain blood cultures, (3) administer broad-spectrum antibiotics, (4) give 30 mL/kg crystalloid for hypotension or lactate ≥4, (5) start vasopressors if fluids fail. When ranking the single most critical intervention, broad-spectrum antibiotics (C) is the answer—every hour of delay increases sepsis mortality by 7-8%. Ideal sequence: blood cultures (B) → immediate antibiotics (C) → fluids (A) and lactate (D) concurrently. If forced to choose one core lifesaving action, antibiotic timing has the strongest direct mortality impact. B, A, and D are all part of the 1-hour bundle, but antibiotics have the most immediate effect on survival.