A 74-year-old with fever, productive cough and confusion has RR 34, SpO2 88%, BP 88/50, lactate 4.2 mmol/L, creatinine 178 µmol/L, and right

Question

A 74-year-old with fever, productive cough and confusion has RR 34, SpO2 88%, BP 88/50, lactate 4.2 mmol/L, creatinine 178 µmol/L, and right lower-lobe consolidation. What is the most appropriate initial management?

Accepted Answer

Sepsis bundle with oxygen, fluids, cultures, early antibiotics and vasopressors if shock persists

Answer

Therapeutic anticoagulation for presumed PE without further assessment

Answer

Oral antibiotics and home care because consolidation localises the source

Answer

Steroids alone for presumed COPD

Answer

Delay antibiotics until sputum culture returns

Severe community-acquired pneumonia with septic shock — RCPSC EM MCQ

A 74-year-old with fever, productive cough and confusion has RR 34, SpO2 88%, BP 88/50, lactate 4.2 mmol/L, creatinine 178 µmol/L, and right lower-lobe consolidation. What is the most appropriate initial management?