Adult Critical Care Specialty (ACCS) Practice Exam

When treating a patient with suspected septic shock, what is the primary initial treatment recommended?

1. Fluid resuscitation

2. Surgery

3. Broad-spectrum antibiotics

4. Vasopressor therapy

The correct answer is: Fluid resuscitation

In the management of suspected septic shock, the primary initial treatment recommended is fluid resuscitation. When a patient is in septic shock, there is often significant vasodilation and increased capillary permeability, leading to decreased intravascular volume and subsequent organ hypoperfusion. Administering intravenous fluids addresses these issues by restoring circulating blood volume, improving cardiac output, and enhancing tissue perfusion. Fluid resuscitation is crucial in the early hours of treatment as it aims to stabilize hemodynamics and prevent progression to more severe complications that can arise from inadequate perfusion. The Surviving Sepsis Campaign guidelines strongly emphasize the importance of rapid fluid administration within the first hour of identifying septic shock. While broad-spectrum antibiotics are vital for targeting the underlying infection and help prevent further systemic complications, they do not address the immediate hemodynamic instability caused by the fluid loss associated with sepsis. Therefore, those medications are often administered concurrently but secondary to fluid resuscitation. Surgical interventions may be necessary later for source control if an abscess or infected tissue is present, but they are not part of initial management. Vasopressor therapy is also vital in cases where fluid resuscitation alone does not restore adequate blood pressure, but this is generally initiated after ensuring adequate