A state is constructed from the multidimensional discrete time series composed of 48 variables about demographics, vital signs, premorbid status, laboratory values, and intravenous fluids and vasopressors received as treatments. Clustering is used to define the state space so that patients in the same cluster are similar w.r.t. the observable properties. An action, or a medical treatment, is defined by the total volume of intravenous fluids and maximum dose of vasopressors over each 4 hour period. The dose of each treatment is divided into 5 possible choices, resulting in 25 discrete actions when combining the two treatments. A reward and a penalty is associated with survival and death, respectively, to optimize patient mortality.