Multiple organ dysfunction syndrome (MODS) Quiz: Ace Your Exams
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A 57-year-old man is brought to the emergency department by ambulance for abdominal pain, vomiting, and decreased oral intake for the past 3 days. He has been having severe epigastric pain that radiates to the back. He takes no medications. Medical history is significant for alcohol use disorder. He drinks 12 beers daily and has done so for the past 15 years. Temperature is 39.2 °C (102.6 °F), pulse is 132/min, blood pressure is 78/44 mmHg, and respirations are 25/min. Pulse oximetry is 87% on 6L 02 by facemask. He is not oriented to place or time. There are poor peripheral pulses and prolonged capillary refill time. Lung examination shows decreased breath sounds at the bases bilaterally. Cardiac examination is normal. There is no JVD. Abdominal examination is significant for severe tenderness in the epigastrium and ecchymosis around the umbilicus. Which of the following is the best next step in management?
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