The first thought should be whether active resuscitation is indicated. For the patient in the terminal phase of illness, adequate sedation may be more appropriate. Should resuscitation be deemed appropriate, an immediate assessment of haemodynamic stability should be made and evidence of coagulopathy sought. A low platelet and fibrinogen level with elevated fibrinogen degradation products (FDPs) is indicative of disseminated intravascular coagulation. CXR and broncho-scopy will help to localize lesions within the major airways and pulmonary parenchyma.

An assessment of the patient's general condition and fitness should be made to dictate the extent of resuscitation that is appropriate.

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