Abstract: The American College of Emergency Physicians(ACEP) issued " Early Care of Adults With Suspected Sepsis in the Emergency Department and Out-of-Hospital Environment: A Consensus-Based Task" in April 2021. ACEP consensus raises doubts about some viewpoints of the SSC 2016 guidelines. The new consensus has more emergency characteristics for adding the principles of early sepsis management in the emergency department and the out-of-hospital environment and adjusting some details of the SSC 2016 guidelines. In present paper, we made a comparative analysis based on the ACEP consensus, the SSC 2016 guidelines and the consensus of Preventing Sepsis Campaign in China(PSCC). All of them were based on the Sepsis-3 consensus. Since emergency physicians often face patients with an uncertain diagnosis, misdiagnosis and inappropriate early treatment may do harm to non-sepsis patients, the ACEP consensus and PSCC consensus coming up with "Suspected Sepsis" concept advocated early prevention and treatment of sepsis. Both of the ACEP consensus and PSCC consensus suggested that qSOFA scoring system plays a limited role in early screening of sepsis. Evaluation for source of infection, using antimicrobials, intravenous fluid administration and using vasopressors are key steps of sepsis intervention in emergency department. Dynamic assessment of the severity of organs damage, patient status and hemodynamic conditions are also critical. Screening of the infected sites is priority to focus on the respiratory system and urinary system, both of them are the most two common sites of infection. For the diagnosed or deemed likely sepsis patients without an identified pathogen, broad-spectrum antibiotics with activity against gram-negative and gram-positive bacteria according to local susceptibility patterns and antibiotics resistance status. The concentration of antibiotics at the site of infection is also an important factor to be considered. Balanced crystalloid solutions is recommended to be used as the primary resuscitation fiuid in ACEP consensus. 30 mL/kg is a reference volume, but is not suitable for all patients. PSCC consensus suggested giving fluid support therapy in theearlier stage. The viewpoint that patient response and volume responsiveness may serve as the best indicators of the appropriateness of fiuid resuscitation volume were accepted by both consensuses. Norepinephrine is the first-line vasopressor. ACEP consensus does not recognize a specific minimum fiuid amount before starting vasopressor support. SOFA scores is recommended to be used to assess severity of emergency sepsis patients. Meanwhile, SpO₂/FiO₂ could be used to replace PaO₂/FiO₂ to simplify SOFA scores under certain conditions. We need to construct the concept of sepsis prevention and blocking. It is necessary to pay attention to infected patients who have not yet developed sepsis, and give intervention early to prevent and block sepsis. Comprehensively considering of different guidelines/consensus and rational use them based on the clinical practice are the key methods to provide timely and efficient treatment to suspected sepsis and sepsis patients in emergency.