Early diagnosis of sepsis: One systematic review of eight studies conducted in infants 0 to 2 months reported that signs of cyanosis, feeding difficulty, grunting, respiratory rate greater than 60 beats per minute, abnormal behavior, or fever may predict sepsis in this population. Two observational studies gave conflicting results. In one, the presence of SIRS in adult patients with community-acquired pneumonia presenting to the ED was a poor predictor of whether or not severe sepsis or septic shock would develop. In another observational study, adult patients who developed severe sepsis while in the ED had vital signs abnormalities and SIRS before arriving to the hospital.Early treatment of sepsis: The treatment of sepsis in a non-ICU setting or in the ED was addressed in three sets of guidelines. All had similar sets of recommendations. These included initiating fluid resuscitation immediately, administering medications such antibiotics, vasopressors, inotropes, low-dose corticosteroids, and activated protein C, and controlling the source of the infection. These recommendations were based on evidence ranging from large randomized controlled trials to expert opinions.