Emergency Medical Technician (EMT) Intermediate Practice Exam

A 21-year-old male has lost approximately 35% of his blood volume from a penetrating chest injury. Which sign would you NOT expect?

1. Widened pulse pressure

2. Rapid heart rate

3. Pale, diaphoretic skin

4. Weak peripheral pulses

The correct answer is: Widened pulse pressure

In cases of significant blood loss, such as a 35% loss of blood volume, the body typically exhibits signs of compensatory mechanisms attempting to maintain perfusion and blood pressure. One of the common responses to blood loss is increased heart rate, often leading to tachycardia; this helps to maintain cardiac output despite the reduced blood volume. Skin changes, such as paleness and diaphoresis (sweating), are also common due to vasoconstriction, which occurs as the body prioritizes blood flow to vital organs. Additionally, weak peripheral pulses are likely to be observed since the reduced blood volume can lead to diminished perfusion in the extremities. A widened pulse pressure, characterized by a large difference between systolic and diastolic blood pressures, is not typically expected in a scenario of acute blood loss. In fact, blood loss usually results in a narrow pulse pressure due to both a decrease in stroke volume and diastolic pressure. Consequently, the anticipatory compensatory mechanisms will not lead to a widened pulse pressure as they would in other conditions like sepsis or certain types of shock. This makes the presence of a widened pulse pressure unlikely in this context of significant hemorrhage.