In a hypotensive patient experiencing septic shock, what should be the first priority?

In the case of a hypotensive patient experiencing septic shock, the first priority is to ensure the patient’s airway, breathing, and circulation are adequately assessed. This is a critical step because septic shock can quickly lead to deterioration in a patient's hemodynamic status, and prompt assessment of vital life functions is essential for determining the urgency and appropriate interventions.

Assessing airway ensures that the patient can breathe adequately, assessing breathing confirms that the lungs are functioning properly, and evaluating circulation involves checking blood pressure and heart rate to gauge perfusion and possible need for immediate interventions like fluid resuscitation or medications. This holistic assessment sets the foundation for all subsequent treatment decisions, including the administration of fluids or antibiotics.

While initiating intravenous fluids and starting antibiotic therapy are indeed critical components of managing septic shock, they should follow the initial assessment to ensure that the patient’s immediate physiological needs are stable. Obtaining a full medical history, while important, is less time-sensitive compared to ensuring that the patient's basic life-support functions are intact. This prioritization aligns with established protocols in managing critically ill patients.