Clinical Case Database / Category: Case Based Discussion

Septic shock

Publication details

Ashis Banerjee MS FRCS FCEM, David Mbamalu FRCS FCEM
Foundation Years Journal, volume 1, issue 6, p.14 (123Doc Education, London, October 2007)


An 83 year old man is brought to the resuscitation room from a nursing home following the acute onset of confusion, which has progressed to a depressed level of consciousness. He is found on arrival to have a heart rate of 130 bpm, blood pressure of 70/40 mm Hg, respiratory rate of 30/minute, capillary refill time of 6 seconds, temperature of 38.7 degrees Centigrade, and arterial oxygen saturation on room air of 89%. His Glasgow coma score is 13/15. He is known to have hypertension, ischaemic heart disease and Type 2 diabetes mellitus. How would you proceed to manage his presenting condition?

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Ashis Banerjee MS FRCS FCEM (Corresponding author)

Consultant/Honarary Senior Lecturer in Emergency Medicine
Chase Farm Hospital
The Ridgeway

David Mbamalu FRCS FCEM

Consultant in Emergency Medicine
Chase Farm Hospital


1.  Harrison D, Welch C, Eddleston J. The epidemiology of severe sepsis in England, Wales and Northern Ireland, 1996 to 2004: Secondary analysis of a high quality clinical database, The ICNARC Case Mix Programme. Critical Care 2006:10(2): R42

2.  Bone RC, Balk RA, Cerra FB. Definitions for sepsis and organ failure andguidelines for the use of innovative therapies in sepsis. The ACCP/SCCM Consensus Conference Committee. American College of Chest Physicians/Society of Critical Care Medicine. Chest 1992;101:1644-1655.


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T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

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