A 75- year old male presents to your ED, with SOB, fever, purulent sputum and a history of recurrent pneumonia. His BP is 70/30, HR is 130, SpO2 90% and RR 30. You suspect he is in septic shock and start fluid resuscitation with crystalloid and broad-spectrum antibiotics. He receives 2L of Ringer’s lactate but his MAP is still < 60. What is your next step?

About the Author: Anton Helman

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.