Emergency Medical Technician (EMT) Intermediate Practice Exam

A patient presents with confusion and slow heart rate. What might be a significant underlying condition?

1. Hypovolemic shock

2. Cardiac dysrhythmia

3. Neurogenic shock

4. Diabetic shock

The correct answer is: Neurogenic shock

In the context of confusion and a slow heart rate, neurogenic shock is a significant underlying condition due to its direct impact on the body's autonomic nervous system. Neurogenic shock occurs when there is a disruption in the sympathetic nervous system, often resulting from spinal cord injuries or severe trauma. This disruption can lead to vasodilation, a drop in systemic vascular resistance, and impaired cardiac output, which often results in bradycardia or a slow heart rate. The confusion exhibited by the patient can be attributed to inadequate cerebral perfusion resulting from the body’s inability to maintain normal blood pressure and appropriate blood flow to the brain. In neurogenic shock, even though blood volume may be normal, the vascular tone is lost, leading to conditions that could impair cognitive function. This combination of symptoms signifies that neurogenic shock might indeed be the cause, especially if there are other indicators or history suggestive of spinal cord injury or trauma. Recognizing this connection helps EMTs swiftly identify the potential physiological changes occurring in their patient.