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Urosepsis with septic shock — SCE Acute Medicine MCQ

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EasySepsis and Infectious EmergenciesUrosepsis with septic shockSCE Acute Medicine

A 63-year-old man presents with suspected urosepsis. Temperature is 39.1 C, HR 128, RR 30, BP 86/52 mmHg, lactate 4.6 mmol/L and he is confused. Blood cultures are taken and IV access is secured. What is the most appropriate next step in management?

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Correct answer: C — Give intravenous broad-spectrum antibiotics immediately with fluid resuscitation and senior escalation

Hypotension, confusion, tachypnoea and high lactate indicate high-risk suspected sepsis requiring immediate antibiotics, fluids and escalation. Cultures should be taken if this does not delay treatment, but treatment should not wait for results. Imaging for obstruction may become vital source control, but resuscitation and antibiotics come first. NICE now separates adult sepsis guidance from the older NG51 pathway, but the principle of urgent treatment in severe illness remains central.

Reference: NICE NG253, UK Sepsis Trust tools, BNF