Had a case the other day and still trying to figure out the best way to treat the patient. This is not a figure out what is wrong thread, but what is the best treatment. Here are the basics:

-Had a hip repair 3 days previous- all went well, no problems.
-On the second post op day, a consult was put in for a possible SBO, but was not put in urgent and was not seen until Monday.

Result- Patient who is normally hypertensive is now in the 90's systolic, the pulse ox is having major trouble picking up a signal.
After a blood gas, it is clear the pt is in acidosis. WBC's are all messed up and she is breathing rapidly.

So the pt is septic, we take them back and it is basically a cluster. We gave etomidate, but it didn't seem to help much. So I am thinking we could have optimized her better- not a long term thing, but even if we did a few things over 30-60 minutes it could have gone much better.

My questions are this:

1. She obviously needed cardiac & BP support- what have you seen given?
2. What should be used for induction agents?
3. What else could be done before bringing a septic patient back that really can't wait for surgery?


My thoughts- Fluids, Blood, levo, bicarb, etc.

Thanks for your help.