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Sepsis handover failure — SCE Acute Medicine MCQ

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EasyPerioperative, Safety and End-of-Life CareSepsis handover failureSCE Acute Medicine

A 29-year-old man presents with postoperative deterioration, treatment refusal or advanced illness. Relevant history includes recent surgery, frailty or a governance issue. On assessment, physiology and communication context require senior decision-making. Investigations show NEWS2 rises to 9 with lactate 4.5 and antibiotics not yet given. What is the most important immediate action?

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Correct answer: E — Escalate urgently using structured handover and deliver sepsis treatment

The key discriminator is that NEWS2 rises to 9 with lactate 4.5 and antibiotics not yet given, which makes Escalate urgently using structured handover and deliver sepsis treatment the single best answer. Give intramuscular adrenaline immediately is less appropriate because it does not address the dominant acute risk in the vignette; Give high-flow oxygen would fit a different presentation or later stage of care. Protect the airway and support ventilation and Perform synchronised cardioversion are suboptimal because they would either delay time-critical treatment or follow the wrong acute pathway. Teaching point: SCE-style acute medicine questions usually test prioritisation using physiology, timing and a guideline-defined threshold, rather than isolated factual recall.

Reference: NICE NG253; RCP NEWS2