22nd February 2024

A 45 year old male is brought to A&E by ambulance after being found collapsed at home by a relative.

A 45 year old male is brought to A&E by ambulance after being found collapsed at home by a relative. He reports feeling weak and fatigued and has recently been off work due to a minor chest infection but is unable to inform you of any further medical history. He looks unwell and is severely hypotensive however his blood pressure is not responding to the IV fluid boluses and he remains tachycardic. His blood test results are as follows:

Na 128 (135-145 mmol/l)
K+ 5.5 (3.5-5 mmol/l)
Ur 9 (3-7 mmol/l)
Cr 128 (60-125 umol/l)
Hb 130 (130-175 g/L male)
WCC 6 (4-11 x 10^9/l)

Select the most appropriate option for initially managing this patient: