Question

A 74-year-old man with presumed urosepsis is hypotensive (BP 80/40 mmHg) and tachycardic after 30 minutes in the emergency department. He has received 30 mL/kg of IV crystalloid but remains hypotensive with lactate 4.5 mmol/L. What is the most appropriate next step in haemodynamic management?

Accepted Answer

Commence a vasopressor such as noradrenaline via central line

Answer

Give another 30 mL/kg fluid bolus

Answer

Start high-dose corticosteroids as first-line

Answer

Begin dopamine infusion as first-line vasopressor

Answer

Observe for another hour without further intervention

Practice question

A 74-year-old man with presumed urosepsis is hypotensive (BP 80/40 mmHg) and tachycardic after 30 minutes in the emergency department. He has received 30 mL/kg of IV crystalloid but remains hypotensive with lactate 4.5 mmol/L. What is the most appropriate next step in haemodynamic management?