Acute Caremiddle twist
A 68-year-old woman is brought in from a residential aged care facility with fever and new confusion. Her temperature is 38.9 degrees Celsius, blood pressure 82/48 mmHg, heart rate 118/min and respiratory rate 28/min. A venous gas taken during the one successful needle puncture shows a lactate of 4.6 mmol/L. Urinalysis is strongly positive for nitrites and leukocytes. Two nurses and the medical registrar have each failed to cannulate her, and twenty-five minutes have passed since she arrived. Which one of the following should be done next?