What is the appropriate treatment for a patient in severe sepsis who is also experiencing third-degree heart block?

In a patient with severe sepsis who is experiencing third-degree heart block, transcutaneous pacing is the appropriate treatment. This is because third-degree heart block, also known as complete heart block, can lead to significant bradycardia and poor cardiac output, which can exacerbate the hemodynamic instability often seen in patients with sepsis. Pacing provides an immediate means to restore an adequate heart rate and improve cardiac function, thus supporting vital organ perfusion.

While intravenous fluid resuscitation, cardioversion, and administration of antibiotics are important components in the management of severe sepsis, they do not directly address the acute cardiac conduction issue presented by third-degree heart block. Adequate fluid resuscitation is crucial for managing sepsis, but in the presence of heart block, the priority shifts to ensuring the heart can effectively pump blood, which is where pacing becomes vital.