NREMT Paramedic Cognitive ExamTraumaMedium
A 32-year-old male presents after a motorcycle collision. He was not wearing a helmet. GCS is 13, and he is complaining of a severe headache. Pupils are equal and reactive to light. Blood pressure is 160/90 mmHg, heart rate is 68 bpm, and respiratory rate is 12 bpm. Based on these findings, which of the following is the most likely cause of his current vital signs?
- AHypovolemic shock
- BSpinal shock
- CIncreased intracranial pressure
- DNeurogenic shock
Show answer & explanationAnswer & explanation
Correct answer: C. Increased intracranial pressure
The patient's vital signs (hypertension, bradycardia, and bradypnea) in the context of a head injury are classic indicators of increased intracranial pressure (ICP), known as Cushing's Triad. This suggests a significant brain injury.
Why the other options are wrong
- A. Hypovolemic shock typically presents with hypotension and tachycardia, which are contrary to the patient's vital signs.
- B. Spinal shock involves temporary loss of motor, sensory, and reflex function below the level of injury, and while it can affect vitals, it doesn't typically present with this specific triad of hypertension and bradycardia.
- D. Neurogenic shock, a type of distributive shock, presents with hypotension and bradycardia, which are opposite to the patient's vital signs.
Cushing's Triad
A set of three primary signs that indicate increased intracranial pressure (ICP): hypertension (elevated systolic blood pressure), bradycardia (slow heart rate), and irregular respirations.
- Indicates severe brain compression.
- Often a late sign of increased ICP.
- Requires immediate intervention to prevent further brain damage.
Memory trick: Cushing's Triad: High Pressure, Slow Heart, Irregular Breath