NREMT Emergency Medical Technician (EMT) Cognitive ExamMedical EmergenciesHard
A 68-year-old female is found unresponsive in her home. Her caregiver reports a history of Alzheimer's disease and that the patient has been refusing to eat or drink for the past two days. Her skin is dry and turgor is poor. Vital signs are BP 80/50 mmHg, HR 120 bpm, RR 24 bpm, Temp 99.8°F (37.7°C). What is the most likely immediate life threat?
- AMyocardial infarction
- BSepsis
- CStroke
- DHypovolemic shock
Show answer & explanationAnswer & explanation
Correct answer: D. Hypovolemic shock
The patient's history of not eating/drinking for two days, combined with signs of dehydration (dry skin, poor turgor) and hypoperfusion (hypotension, tachycardia), strongly indicates hypovolemic shock due to severe dehydration. While other conditions are possible, the immediate and most likely life threat from the provided information is the lack of circulating volume.
Why the other options are wrong
- A. Myocardial infarction can cause shock, but the history of dehydration and associated physical findings make hypovolemic shock a more direct and probable immediate cause for the current presentation.
- B. While sepsis is possible in elderly patients, the primary cause of unresponsiveness and shock is more directly linked to severe dehydration in this scenario. Sepsis would likely present with a higher fever and other infectious signs.
- C. Stroke is possible but typically presents with focal neurological deficits, which are not described. The systemic signs point more to a circulatory problem.
Geriatric Hypovolemic Shock
A life-threatening condition in elderly patients caused by severe fluid loss, often due to dehydration, leading to inadequate tissue perfusion.
- Elderly are prone to dehydration.
- Symptoms include dry skin, poor turgor, hypotension, tachycardia, altered mental status.
- Rapid recognition and fluid resuscitation are critical.
Memory trick: Dehydration Drains, Shock Remains