Community-acquired pneumonia with sepsis

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Educational simulation. Not for real patient care and not a substitute for supervised training. Always follow local protocols.

What you will practise

Recognise the clinical features of community-acquired pneumonia and the signs of sepsis in a patient with a chest infection.
Prioritise early assessment, oxygen, cultures, antibiotics and fluids over diagnostic completeness.
Apply a validated severity score together with clinical judgement to decide the level of care.
Explain why blood cultures are taken before antibiotics without delaying them in a sick patient.
Identify triggers for senior and critical care review in a patient who responds poorly to initial treatment.
Plan safe discharge with safety-netting, follow-up and prevention measures.

Which of the following organs most typically develops a red (haemorrhagic) infarct after arterial occlusion?
A 68-year-old woman with a urinary tract infection has temperature 39.1 C, heart rate 128, respiratory rate 28, BP 82/48 mmHg and confusion. Lactate is 4.5 mmol/L. What is the best immediate management according to the Surviving Sepsis Campaign 2021 guidelines?
A 67-year-old man with severe COPD has an exacerbation, SpO2 of 78 percent on air, RR 28, and drowsiness. He is given 100 percent oxygen and becomes more drowsy, and blood gas shows pH 7.24 with PaCO2 9.2 kPa. What is the best explanation and management?
A 78-year-old woman has fever, productive cough and right lower zone crackles. She is newly confused, urea is 9 mmol/L, RR 32 and BP 92/58 mmHg. How many CURB-65 points does she score, and what does this imply?
A man with acute gastrointestinal bleeding has a pulse of 124/min, blood pressure 85/55 mmHg and cool peripheries. Which initial intravenous fluid is most appropriate while blood is being arranged?