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The care home said he wasn’t himself

Clinical caseEmergency4 min
The care home said he wasn’t himself

A 68-year-old care-home resident arrives confused and drowsy. Temperature 36.1°C, respiratory rate 28, BP 86/50, prolonged capillary refill and mottled skin. Lactate is 4.2 mmol/L. No source is obvious on examination.

Your registrar wants a CT abdomen and pelvis to find the source before committing to antibiotics. What happens first?