QuestionSBA
QuestionChoice
This woman has sepsis from the cellulitis in her leg. It is important to recognise and treat sepsis quickly. The treatment for sepsis includes the sepsis 6: take lactate level, blood culture and urine output, and administer oxygen, IV fluid and IV antibiotics. In this case, IV fluids are most important because of her haemodynamic instability.
10027921
a
Start IV fluids
QuestionChoice
Oxygen does make up part of the sepsis 6, so is important to consider here. However, this woman's oxygen saturations are currently stable so oxygen is not currently indicated. It would be more important to start IV fluids as she is hypotensive.
10027924
d
Give Oxygen
QuestionChoice
The origin of the infection for this woman is cellulitis in her leg. Therefore, a skin swab may help advise narrow-range antibiotics based on what is cultured. However, this woman is showing red flag signs of sepsis so needs to be stabilised and treated first. This will include broad-spectrum antibiotics.
10027922
b
Skin swab
QuestionChoice
Paracetamol is used to treat pyrexia, but in this case, it is important to promptly treat the cause of the fever. The cellulitis this woman has is now causing sepsis which may be life-threatening if not treated quickly.
10027923
c
Prescribe paracetamol
QuestionChoice
There is a bacterial infection going on so antibiotics would be important. However, she is acutely unwell with sepsis so these would need to be IV to act quickly and effectively.
10027925
e
Oral antibiotics
Concept
Chapter
2693
4035
Sepsis
Topic
161
Emergency Medicine
17982
A 45-year-old woman is brought to A+E after becoming increasingly unwell. She complains of feeling feverish and has a red patch on her leg. She states she scratched the area while gardening last week. On examination, there is an erythematous, tender patch on her right shin. She tells you it has been getting bigger. The area is also warm to touch.
Her observations include a temperature of 38.7 degrees, a heart rate of 120/min, a blood pressure of 90/40 mmHg, a respiratory rate of 21 and oxygen saturation of 94%.
What is the first step in managing this patient?
a