23rd February 2024

A 46 year old male presents to his local emergency department with symptoms including sudden onset of nausea and vomiting, global weakness, severe fatigue and persistent dizziness.

A 46 year old male presents to his local emergency department with symptoms including sudden onset of nausea and vomiting, global weakness, severe fatigue and persistent dizziness. On examination he appears confused and is tachycardic and hypotensive despite IV fluid resuscitation. He has a history of severe asthma and was placed on a high dose of oral prednisolone 3-weeks ago to try and control his breathing difficulties. He recently stopped the medication without seeking healthcare advice since he felt his breathing had sufficiently improved. He also has a history of hypothyroidism, hypertension and depression.

Select the single, most appropriate acute management option which should be initiated first to help treat this patient’s condition.