1st step in management of septic shock?

• A. IV fluids
• B. Vasopressors
• C. Broad-spectrum antibiotics
• D. Glucose control

Answer: (A)

In septic shock, the immediate problem is profound relative hypovolemia and vasodilation that drop perfusion. The first action is to rapidly restore intravascular volume with an isotonic crystalloid bolus to improve preload and blood pressure. A common target is about 30 mL/kg administered within the first 3 hours, which helps restore adequate organ perfusion before addressing other issues. If blood pressure remains low after this resuscitation, vasopressors such as norepinephrine are started to maintain a map of about 65 mmHg. Broad-spectrum antibiotics are essential and should be given promptly within the first hour of recognition, but they do not acutely correct the hemodynamic collapse, so they are started as soon as possible, often in parallel with fluid resuscitation. Glucose control is not the immediate priority in the initial management of septic shock.