A 72-year-old woman presents to the emergency department from home with fever, productive cough, confusion and hypotension (BP 85/50 mmHg, HR 118 beat...

Question

A 72-year-old woman presents to the emergency department from home with fever, productive cough, confusion and hypotension (BP 85/50 mmHg, HR 118 beats/min, RR 28 breaths/min, SpO2 90% on room air). She is oliguric and has a lactate of 4.5 mmol/L. Chest X-ray shows right lower lobe consolidation. What is the single most important treatment intervention that should be commenced within the first hour?

Accepted Answer

Commence IV broad-spectrum antibiotics targeting likely pathogens

Answer

Obtain sputum and blood cultures before any therapy

Answer

Commence low-dose oral antibiotics and review in 24 hours

Answer

Arrange urgent CT pulmonary angiography

Answer

Administer high-flow nasal oxygen only

au-acem MCQ (SBA): Sepsis secondary to pneumonia