Introduction

Sepsis is one of the main causes of mortality worldwide and is a life-threatening emergency that needs early recognition and rapid treatment to enhance outcomes. Emergency departments (EDs) globally continue to face difficulties in promptly identifying sepsis due to nonspecific presentations and varying resource levels.

Methods

A literature review of international ED studies from 2020 to 2025 was conducted to find and analyze advances in sepsis diagnostic criteria, triage systems, antibiotic timing, and patient outcomes. Key PubMed-indexed studies, reviews and guidelines were analyzed.

Results

The Sepsis-3 definition (infection with organ dysfunction) has been widely adopted. Numerous screening methods (e.g., qSOFA, SIRS, NEWS) are employed to aid early diagnosis. Modern approaches, such as machine-learning triage algorithms, outperform traditional scores in terms of accuracy. According to a 2024 meta-analysis, ED sepsis alert systems have improved care processes by lowering mortality and by facilitating faster delivery of sepsis bundle elements (e.g., fluids, antibiotics). Early antibiotic administration remains essential. A 2020 meta-analysis reported no significant difference in mortality between antibiotics administered at 0–1 hour of sepsis and those given at 1–3 hours, despite the fact that global guidelines recommend using antibiotics within 1 hour. However, a larger 2024 meta-analysis, encompassing around 190,000 patients, showed that antibiotics given within 3 hours significantly increases survival compared to later administration. Though outcomes depend on factors like provider buy-in and screening accuracy, implementation of ED sepsis protocols has consistently increased adherence to guidelines.

Conclusions

ED-focused sepsis initiatives worldwide have advanced early detection and accelerated management over the last five years. Protocol-driven care and enhanced triage tools have increased adherence and show promising reduction in mortality. To further enhance patient outcomes worldwide, a structured and rapid-response approach to ED sepsis care is essential.