A 70-year-old man presents to a Gold Coast ED, triage category 1, with pneumonia and septic shock. He has received 30 mL/kg crystalloid and

Question

A 70-year-old man presents to a Gold Coast ED, triage category 1, with pneumonia and septic shock. He has received 30 mL/kg crystalloid and antibiotics. BP remains 78/44, lactate is 5.9, urine output is low and bedside echo shows reasonable LV function. What is the most appropriate management?

Accepted Answer

Start noradrenaline through appropriate access and seek ICU care

Answer

Give repeated unlimited crystalloid without vasopressor

Answer

Start oral antibiotics and discharge

Answer

Wait for blood culture growth before escalation

Answer

Begin beta-blocker infusion

Septic shock — ACEM Fellowship MCQ

A 70-year-old man presents to a Gold Coast ED, triage category 1, with pneumonia and septic shock. He has received 30 mL/kg crystalloid and antibiotics. BP remains 78/44, lactate is 5.9, urine output is low and bedside echo shows reasonable LV function. What is the most appropriate management?