Emergency Medical Technician (EMT) Intermediate Practice Exam

If a patient shows signs of shock without external injury, what should be suspected?

1. Pelvic fracture

2. Intraabdominal bleeding

3. Cardiac tamponade

4. Pneumothorax

The correct answer is: Intraabdominal bleeding

When a patient exhibits signs of shock without any visible external injury, intraabdominal bleeding is a key consideration. This is because internal bleeding may occur from various sources such as a splenic or liver injury, which can happen in the absence of external trauma signs. The internal nature of the injury may not be immediately apparent; however, it can lead to significant blood loss, resulting in shock. Signs of shock include altered mental status, weak pulse, rapid heart rate, low blood pressure, and cool, clammy skin. When these signs occur without external trauma, the clinician must think critically about potential underlying issues, such as injuries that may not present obvious external bleeding or bruising. In contrast, while pelvic fractures can lead to shock, they typically present with visible abnormalities and may show signs of external trauma. Cardiac tamponade and pneumothorax also have distinct signs and symptoms that may typically present alongside other physical examination findings. Therefore, in the absence of obvious external injury, intraabdominal bleeding becomes the most plausible suspicion, emphasizing the importance of further assessment and imaging to determine the source of shock in such patients.