NREMT Paramedic Cognitive ExamOperationsHard
A paramedic is managing a 72-year-old female with suspected sepsis. Her blood pressure is 88/50 mmHg, heart rate 118 bpm, respiratory rate 24 bpm, and she is lethargic. Her temperature is 101.5°F (38.6°C). After ensuring airway and breathing, which of the following interventions should the paramedic prioritize?
- AAdministering a vasopressor to increase blood pressure.
- BAdministering a broad-spectrum antibiotic.
- CObtaining a 12-lead ECG to assess for cardiac involvement.
- DInitiating rapid IV fluid resuscitation with crystalloids.
Show answer & explanationAnswer & explanation
Correct answer: D. Initiating rapid IV fluid resuscitation with crystalloids.
In septic shock, the primary prehospital intervention after securing the airway and breathing is aggressive fluid resuscitation with crystalloids to address the relative hypovolemia and improve perfusion. Vasopressors are typically used if fluid resuscitation alone is insufficient. Antibiotics are crucial but usually administered in the hospital setting, and an ECG is secondary to life-threatening perfusion issues.
Why the other options are wrong
- A. Vasopressors are a second-line treatment, used after adequate fluid resuscitation for persistent hypotension.
- B. Antibiotics are essential for sepsis but are typically administered in the hospital setting, as prehospital administration is not standard practice and timing is less critical than immediate hemodynamic support.
- C. While an ECG is important, it is not the immediate priority over addressing the life-threatening shock state in sepsis.
Prehospital Sepsis Management
Early recognition and aggressive treatment of sepsis in the prehospital setting to improve patient outcomes.
- Prioritize airway, breathing, circulation.
- Aggressive fluid resuscitation for hypotension.
- Rapid transport to appropriate facility.
Memory trick: Fluids First, for Febrile Shock.