Section 3 - Hemorrhage and Shock Part 3

Blood pressure is maintained during the early compensated phase of shock, as long as the patient’s arterial tone is healthy. Vasoconstriction and an increased heart rate accomplish this compensation until the arterial tone fails, cardiac output is insufficient or the blood supply becomes depleted (decompensated shock). The EMT should not wait for a drop in the blood pressure to diagnose a patient with shock, this is especially true with pediatric patients who can compensate much longer than an adult (a child can lose up to half their blood volume and still exhibit a blood pressure that is within normal ranges).

When perfusion is negatively impacted during shock, a narrowing of the pulse pressure will occur. Pulse pressure is the difference between the systolic and diastolic pressures. As the patient’s shock progresses the pulse pressure will narrow, in other words the systolic will decrease while the diastolic will increase. Obtaining frequent blood pressures will identify such trends as narrowing pulse pressure and is a sign of worsening hypoperfusion.

With the above information, answer the following questions based on the prior activity (Richard the assistant manager of the hardware store complaining of abdomen pain).