Hello everyone, I love to offer my opinion on this topic. Previous information about myself: 4 years CVICU, 1 year of Neuro and 11 months left in anesthesia school. Personally I would probably would not give 2L of fluid upfront. I understand that rationale for fluid resuscitation for septic patient. This patient still maintain more than adequate blood pressure despite the state of tachycardia. If they are truly concerned for sepsis...blood cultures should be drawn, central line and A line placed. Serial laps and I would guide my fluid management from there.
In addition, I am concerned with desatuation. Crystallioid doesn't stay intravascularly more than 45 mins...so if they were to really want to fluid resuscitate this patient..they should be a bit more aggressive. Judging from the clinical presentation, I would do a bit more work up and not rush to give 2 L upfront....1 L..may be but not 2.