28th May 2025

A 30-year-old woman is admitted to A&E with fever, breathlessness, and a cough.

A 30-year-old woman is admitted to A&E with fever, breathlessness, and a cough. She has no medical history and is not on any regular medication. Her observations are BP 80/50mmHg, HR 130bpm, RR 32/min and temperature 39.5. Initial VBG shows a lactate of 5.6. She is given IV antibiotics and 2 litres of IV NaCl 0.9% as fluid boluses via a pressure bag.

You review her after 30 minutes, and she has a temperature of 38, RR 26/min, HR 110bpm, BP 85/50 and oxygen saturation 92% on 1L NC. She has a lactate of 4 on VBG. Her blood tests are pending. Her chest x-ray shows right basal consolidation. She is reviewed and accepted by ITU.

As well as fluid resuscitation, which of the following medications is most appropriate to give?

Select the SINGLE most appropriate option from the list below. Select ONE option only.