[Initial management of sepsis in the emergency room: "Time is life"].

Sepsis is a fairly common disease process in our population. Even with aggressive treatment, morbidity and mortality remain high. The initial evaluation of these patients with sepsis, severe sepsis and septic shock may increase survival. Understanding the pathophysiological process is an integral part of improving outcomes. Recent studies have shown that with the systematic use of aggressive fluid expansion, broad-spectrum antibiotics as well as inotropes and vasopressors a decrease in mortality may be achieved. Our efforts must be geared towards a structured early diagnosis and treatment. With the right tools and approach we will be able to keep ourselves ahead of this condition in order to improve the health of our fellow patients in Puerto Rico and the rest of the world.