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You are working in the emergency department (ED) of a community hospital when the ambulance arrives with A.N., an 1818-year-old woman who was caught in a house fire. She was sleeping when the fire started and managed to make her way out of the house through thick smoke. The emergency medical system crew initiated humidified oxygen at 15 L/min15 \mathrm{~L} / \mathrm{min} per nonrebreather mask and started a 1616-gauge IV with lactated Ringer's solution. On arrival to the ED, her vital signs are 100/66,125,34100/66, 125, 34, SaO293%\mathrm{SaO}_2 93 \%. An additional 1616-gauge IV is inserted. She appears anxious and in pain.

Eighteen hours after the injury, the NAP reports these vital signs for A.N. and states that the urine output for the past hour was 2020 mL.

 Vital Signs  Blood pressure 90/50 mmHg Heart rate 110 beats /min Respiratory rate 24 breaths /min\begin{aligned} &\text { Vital Signs }\\ &\begin{array}{ll} \text { Blood pressure } & 90 / 50 \mathrm{~mm} \mathrm{Hg} \\ \text { Heart rate } & 110 \text { beats } / \mathrm{min} \\ \text { Respiratory rate } & 24 \text { breaths } / \mathrm{min} \end{array} \end{aligned}

What treatment do you anticipate?

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Treatments that could be started or placed on standby include vasopressors\textbf{vasopressors} and broad-spectrum antibiotics\textbf{broad-spectrum antibiotics} should be started in addition. It is also possible to have a culture and sensitivity\textbf{culture and sensitivity} of the wound area to detect the pathogens present and what antibiotics these bacteria are sensitive to.

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