Within the WFPICCS project, resuscitation package compliance ranged from 24% to 52%, and administration package compliance ranged from 10 to 25 centers. Similarly, in the Surviving Sepsis Campaign, the overall managed package adherence rate started at 18% and increased to about 36% after two years. The news isn't good for children in areas with ample resources. Intensive efforts have improved compliance in Utah and Texas, but this remains suboptimal, with up to 80% compliance for intravenous fluids, antibiotic administration, and lactate assessment. A follow-up review of the UK guidelines for the treatment of meningococcemia reported delayed recognition and delayed intravenous infusion and inotropic drugs, with 36% adherence to pre-ICU intensive care. India has been found to comply with ACCM guidelines by a physician review. This poor compliance was primarily due to lack of skills and knowledge. Adherence to the guidelines was also poor in other parts of the world, including Africa, where less than 50% of his guidelines in the Survival Sepsis Campaign were implemented. The main reason was lack of resources and lack of education. Low adherence to sepsis guidelines was also noted in Germany, where there was a gap between perception and reality. Physicians assumed his low tidal volume compliance rate was 80%, but in reality he was between 2.6% and 17%. Similarly, adherence to glycemic control was 66% when it was actually 6%. Suboptimal management associated with non-adherence to sepsis guidelines has also been reported in children in France, the United Kingdom, and Australia. In most cases, suboptimal management results from underestimation of disease severity, delays in physician administration of antibiotics or fluids, inadequate hydration, and inadequate inotropic support. Adherence improved outcomes, but adherence to some elements of the guidelines was suboptimal in all these cases, and in many cases the entire bundle was available to only a small number of patients. Similar results were seen among adults in the Sepsis campaign, with significant reductions in mortality with adherence to CPR and treatment packages. The main causes of non-adherence to guidelines are multiple, lack of awareness of sepsis, lack of familiarity with or awareness of sepsis guidelines, disagreement with specific guidelines or disagreement with guidelines as a whole, motivation lack and so on. In addition, there are many external barriers to implementing the guidelines. Additionally, some argue that sepsis guidelines are too numerous, while others contain outdated and conflicting information. Furthermore, it may turn into a performance indicator that determines hospital accreditation. In our field experience, physicians were skeptical when sepsis guidelines were introduced. Triage systems detect sepsis. We believed that sepsis screening in ED was unnecessary because it is robust enough for some feel that the pediatric early warning system on the ward serves the same purpose, while others feel that the introduction of sepsis guidelines implied mismanagement of sepsis in advance. Because sepsis is caused by the host's response to infection, the populations at greatest risk are those most at risk of contracting a serious infection, including the very young and the very old, diabetes, cancer, and disease. Includes persons with an underlying non-communicable disease, such as those with or treatment-related immunosuppression. The definitions of sepsis and septic shock were updated in January 2016 to identify patients at increased risk of adverse events, particularly those requiring intensive care unit (ICU) care and those at increased risk of death. it was done.