Acute Caremiddle twist
An 81-year-old woman was brought from a residential aged care facility two hours ago with fever and dysuria; her observations were normal at triage and she was placed in the waiting area. She is now rousable but disoriented, with a respiratory rate of 26 breaths per minute, blood pressure of 88/50 mmHg and temperature of 38.7 degrees Celsius. Venous lactate is 3.4 mmol/L. Two sets of blood cultures have just been taken, a mid-stream urine specimen has not yet been obtained, and the registrar has requested computed tomography of the abdomen. By which one of the following times should intravenous antibiotics be given?