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Septic shock — RCPSC EM MCQ

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HardInfectious disease emergenciesSeptic shockRCPSC EM

A 63-year-old with pyelonephritis is febrile and confused. BP remains 78/44 mmHg after 30 mL/kg crystalloid, lactate is 5.3 mmol/L, creatinine is 210 micromol/L, and urine output is minimal. What is the most appropriate initial management?

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Correct answer: D — Start norepinephrine, give early antibiotics, and arrange ICU-level care

Start norepinephrine, give early antibiotics, and arrange ICU-level care is correct: the clues indicate Septic shock and this option addresses the immediate ED priority. The distractors delay care, target a less likely problem, or are unsafe in this physiology.

Reference: BC Emergency Department Sepsis Guidelines; Surviving Sepsis principles