Question

A 68-year-old man (92 kg) presents to the ED with fever, confusion, SBP 84 mm Hg, MAP 58 mm Hg after arrival, RR 28/min, lactate 5.1 mmol/L, and suspected pneumonia. Time zero was triage at 14:10 and it is now 14:25; no IV fluids have been given yet. According to contemporary sepsis guidance, which immediate action is indicated as part of initial resuscitation?

Accepted Answer

Administer 30 mL/kg of IV crystalloid rapidly and complete within the first 3 hours

Answer

Delay fluids and start norepinephrine immediately via peripheral IV

Answer

Give 5 mL/kg crystalloid while awaiting central venous pressure measurement

Answer

Begin hydrocortisone 200 mg/day immediately

Answer

Defer fluids until a point-of-care echocardiogram confirms fluid responsiveness

Practice question