A 45-year-old male patient on an interfacility transport is diagnosed with septic shock. The patient exhibits hypotension despite adequate fluid resuscitation and is currently on vasopressors. What is the next crucial step in managing this patient?
Monitor central venous oxygen saturation (ScvO2) and optimize tissue perfusion.
Administer another dose of broad-spectrum antibiotics.
Given the severity of septic shock, monitoring and optimizing tissue perfusion is paramount. Central venous oxygen saturation (ScvO2) monitoring helps assess whether the tissues are receiving adequate oxygen. If ScvO2 is low despite appropriate initial steps, further interventions such as optimizing cardiac output, transfusion of red blood cells, or increasing oxygen delivery may be necessary. Administering a broad-spectrum antibiotic is critical at the beginning of sepsis treatment, not next step after vasopressors. Increasing vasopressor dose can maintain blood pressure but does not directly improve tissue oxygenation. Initiating hemodialysis is needed in cases of acute kidney injury and not directly related to improving perfusion in septic shock.
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