A 62-year-old man arrives with fever and confusion after urinary symptoms. Triage acuity is ESI 1; T 103.0 F, BP 76/42 mm Hg, HR 138/min, RR 30/min.

Question

A 62-year-old man arrives with fever and confusion after urinary symptoms. Triage acuity is ESI 1; T 103.0 F, BP 76/42 mm Hg, HR 138/min, RR 30/min. Skin is mottled, lactate is 5.4 mmol/L, and urinalysis shows pyuria and nitrites. Which of the following is the most appropriate initial action?

Accepted Answer

Begin sepsis resuscitation with IV crystalloids, broad-spectrum antibiotics, and vasopressors if needed

Answer

Give oral antibiotics and discharge

Answer

Start antihypertensive therapy

Answer

Treat fever with acetaminophen alone

Answer

Wait for urine culture before antibiotics

Septic shock — ABEM Board MCQ

A 62-year-old man arrives with fever and confusion after urinary symptoms. Triage acuity is ESI 1; T 103.0 F, BP 76/42 mm Hg, HR 138/min, RR 30/min. Skin is mottled, lactate is 5.4 mmol/L, and urinalysis shows pyuria and nitrites. Which of the following is the most appropriate initial action?