35 year old Mona developed feature of septicemia. Shock in form of hypotension and low urine output. She was being T/t for colonic necrosis. What will be the m/n -

Ans. is 'b' i.e. IV fluids only This patient is in septic shock. Management of septic shock The management begins in usual order i.e. ABC --> first airway and breathing. Then the hypotension is taken care of by infusion of balanced salt solution. Next antibiotics are given to take care of sepsis. Vasopressors (like dopamine, dobutamine, epinephrine) form 2nd-line of therapy. They are used if the patient remains hypotensive despite restoration of intravascular volume. Sabiston writes - "Patients with restored intravascular volume who remain in septic shock should be given drugs to improve cardiac function, namely dopamine, dobutamine, and epinephrine."