Question

A patient is brought to the emergency department after a motor vehicle crash. He is conscious and there is no obvious external trauma. He arrives at the hospital completely immobilized on a long spine board. His blood pressure is 60/40 mm Hg and his heart rate is 70 beats per minute. His skin is warm. Which one of the following statements is TRUE?

Answer 1

The true statement for a patient with normal heart rate and hypotension after a trauma, with no external injuries and warm skin, likely indicates neurogenic shock or an unseen injury such as internal bleeding. Immediate medical attention is required to diagnose and treat the underlying cause.

Step-by-step explanation:

A patient is brought to the emergency department after a motor vehicle crash with a blood pressure of 60/40 mm Hg and a heart rate of 70 beats per minute. His skin is warm, and he has been immobilized on a long spine board. The warm skin, in contrast to the low blood pressure and normal heart rate, could indicate a spinal shock, particularly neurogenic shock where there is a loss of sympathetic tone causing vasodilation, which can present as hypotension (low blood pressure) without compensatory tachycardia (increased heart rate). It may also suggest the presence of internal bleeding or other injuries not immediately apparent without external trauma. Immediate medical evaluation and intervention is critical to address the potential life-threatening conditions.

The statement that is TRUE in this scenario is that the normal heart rate in the face of hypotension is unusual, considering the patient has experienced a traumatic event. Normally, you would expect a bodily response that would cause an increase in heart rate as a compensatory mechanism to maintain cardiac output and blood pressure.