Fluid resuscitation

• Initial resuscitation should be with crystalloids.
• At least 30ml/kg should be administered within the first 3hrs of presentation.
• Clinical and haemodynamic response should continually be monitored, along with the presence of any pulmonary oedema.

Lactate

• Normal lactate is <2mmol/L.
• Early lactate measurement is useful both as a prognostic marker and as a serial measurement to guide treatment and tissue perfusion.
• If the initial lactate was >2mmol/L, it should be repeated within 6hrs

Antibiotics

• Blood cultures should be obtained prior to antibiotic administration.
• Broad spectrum antibiotics should be given within 1hr of presentation.
• The choice of antibiotics can be rationalised once a causative organism is identified or, there is clinical improvement (this should be discussed with a senior first).