The recommendation for an initial fluid bolus of 30 mL/kg was downgraded from a strong recommendation to a weak recommendation, based on the low quality of evidence. However, resuscitation should start immediately.
Balanced crystalloid solution (e.g., lactated Ringer’s solution) should be used (rather than normal saline) for resuscitation.
Administration of vasopressors should be initiated via peripheral access, as opposed to waiting for placement of central venous access.
Patients with ongoing vasopressor requirements should receive intravenous corticosteroids (this recommendation was strengthened); however, administration of intravenous vitamin C is explicitly not recommended.