Finding time zero: how smart diagnostics and AI are reshaping sepsis care

Sepsis stands apart from the other emergencies that define time-critical care. While trauma, stroke, and STEMI are anchored by a discrete lesion and a confirmatory test, sepsis offers no such certainty – no single biomarker, no clear identifiable moment of onset, no clean diagnostic threshold. Clinicians are instead asked to recognize a shifting constellation of signs that vary by both pathogen and a fluid host immune response, often without the reassurance of positive cultures. This review examines the paradox at the heart of emergency sepsis care, which is the demand for immediate, decisive treatment of a syndrome that resists reliable, timely characterization.