NREMT Paramedic Cognitive ExamCardiology & ResuscitationEasy
A 40-year-old female presents with sudden onset of dizziness, weakness, and lightheadedness. Her skin is cool, pale, and clammy. Vital signs are BP 80/50 mmHg, HR 120 bpm, RR 24 bpm, SpO2 96%. Her ECG shows sinus tachycardia. What type of shock is MOST likely occurring?
- AHypovolemic shock
- BObstructive shock
- CDistributive shock
- DCardiogenic shock
Show answer & explanationAnswer & explanation
Correct answer: A. Hypovolemic shock
The patient's presentation of dizziness, weakness, cool/pale/clammy skin, hypotension, and tachycardia (with a normal ECG) in the absence of obvious cardiac or obstructive causes is highly suggestive of hypovolemic shock. This refers to inadequate circulating blood volume.
Why the other options are wrong
- B. Obstructive shock would involve a physical obstruction to blood flow (e.g., tension pneumothorax, pericardial tamponade), which is not indicated here.
- C. Distributive shock (e.g., septic, anaphylactic, neurogenic) typically presents with warm, flushed skin due to vasodilation, although late stages can be cool.
- D. Cardiogenic shock would typically involve signs of heart failure or dysrhythmias, not just sinus tachycardia.
Hypovolemic Shock Presentation
Hypovolemic shock results from inadequate circulating blood volume, presenting with signs of poor perfusion such as hypotension, tachycardia, cool/pale/clammy skin, and altered mental status.
- Caused by significant fluid loss (e.g., hemorrhage, severe dehydration, burns).
- Compensatory mechanisms include increased heart rate and peripheral vasoconstriction.
- Treatment focuses on identifying and stopping fluid loss, and aggressive fluid resuscitation.
Memory trick: H.O.C.D. - Hypo, Obstructive, Cardio, Distributive