Acute Caremiddle twist
A 68-year-old woman is admitted with fever and dysuria. Blood cultures were taken and she received gentamicin and amoxicillin within 40 minutes of arrival. She has now had 1500 mL of sodium chloride 0.9% over 40 minutes. Blood pressure is 78/40 mmHg, having been 84/46 mmHg before the fluid; pulse 118/min, respiratory rate 26/min, oxygen saturation 95% on 2 L/min. Her hands are warm. Venous lactate is 4.2 mmol/L. A 16-gauge cannula in the right antecubital fossa is running freely. The intensive care registrar will arrive in 20 minutes. Which one of the following should be done next?