North Carolina EMT State Practice Exam

How does spinal shock typically differ from other forms of shock?

1. It presents with tachycardia

2. It causes increased blood pressure

3. It is accompanied by bradycardic pulse rate

4. It has immediate respiratory distress

The correct answer is: It is accompanied by bradycardic pulse rate

Spinal shock is a unique and specific condition that occurs following a spinal cord injury, and one of its hallmark features is the presence of a bradycardic pulse rate, which means a slower than normal heart rate. This phenomenon arises because spinal shock disrupts the normal sympathetic nervous system responses that regulate heart rate and blood pressure. In spinal shock, the loss of sympathetic tone due to injury leads to unopposed vagal activity, which can cause the heart rate to decrease. This is in contrast to other forms of shock, such as hypovolemic or cardiogenic shock, where the body generally responds to low blood volume or low cardiac output with tachycardia (increased heart rate) as a compensatory mechanism. Understanding this distinction is critical for EMTs and healthcare providers, as it influences the management and treatment of patients presenting with spinal injuries. Identifying bradycardia in the context of spinal shock can alert the provider to possible underlying spinal cord injuries and guide appropriate care.