Fever, hypotension, confusion — septic shock; cultures, broad antibiotics, fluids within the hour. Sepsis (infection + organ dysfunction — SOFA; septic shock — vasopressors needed: 1-hour bundle — blood cultures, broad-spectrum antibiotics, 30ml/kg fluids, lactate, vasopressors — norepinephrine): source control (drain abscess, remove lines). Tropical — leptospirosis (Weil's — jaundice, renal — doxycycline/penicillin), scrub typhus (eschar — doxycycline/azithromycin), kala-azar (rK39 — amphotericin). COVID-19 (hypoxia — dexamethasone, oxygen ladder — nasal → HFNC → NIV → ventilator; anticoagulation; remdesivir early). The hour is the bundle — delay kills in sepsis.