Recent guidelines for how to best manage septic shock have changed. Gone are recommendations for central venous oxygen saturation monitoring and goal-directed therapy. In is the concept that septic shock be treated as an emergency with rapid administration of antibiotics and large amounts of fluids. Our discussants Derek C. Angus, MD, MPH, and Michael D. Howell, MD, MPH, discuss why these recommendations have changed. This is the second podcast in the Surviving Sepsis guideline series. The first podcast reviewed what recommendations are in the guideline itself. Article discussed in this episode: Management of Sepsis and Septic Shock Speakers: JAMA Associate Editor Derek C. Angus, MD, MPH, University of Pittsburgh, and Michael D. Howell, MD, MPH, University of Chicago.