Which signs would suggest septic shock in the field?

• A. Fever or hypothermia, tachycardia, tachypnea, hypotension or signs of poor perfusion, and altered mental status.
• B. Normotension with bradycardia and calm mental status.
• C. Hyperthermia with hypertension and no perfusion changes.
• D. Only chest pain with stable vital signs.

Answer: (B)

Recognizing septic shock in the field centers on spotting a systemic response to infection that compromises tissue perfusion. The classic signs are fever or hypothermia, tachycardia, tachypnea, hypotension or signs of poor perfusion, and altered mental status. This cluster captures the key features of septic shock: temperature disturbance, rapid heart rate, rapid breathing, reduced blood pressure or perfusion, and changes in consciousness. The other patterns don’t fit septic shock—for example, a calm patient with normal blood pressure and bradycardia isn’t typical of sepsis progression; hyperthermia with high blood pressure and no perfusion changes misses the perfusion deficit; chest pain with stable vitals isn’t indicative of septic shock. In the field, look for the combination of temperature disturbance, fast heart rate, fast breathing, signs of poor perfusion or low blood pressure, and mental status changes to identify septic shock.