A 64-year-old with suspected septic shock has MAP 52 mmHg after 30 mL/kg lactated Ringer bolus and broad-spectrum antibiotics. Lactate is 4.2 mmol/L. ...

Question

A 64-year-old with suspected septic shock has MAP 52 mmHg after 30 mL/kg lactated Ringer bolus and broad-spectrum antibiotics. Lactate is 4.2 mmol/L. Next best step?

Accepted Answer

Begin norepinephrine to target MAP ≥65 mmHg

Answer

Add vasopressin as first vasopressor

Answer

Start dopamine infusion

Answer

Give additional colloid bolus before any vasopressor

Answer

Initiate high-dose corticosteroids immediately in all cases

Septic Shock (Vasopressors) — MRCEM SBA MCQ

A 64-year-old with suspected septic shock has MAP 52 mmHg after 30 mL/kg lactated Ringer bolus and broad-spectrum antibiotics. Lactate is 4.2 mmol/L. Next best step?