Paramedic National Registry Practice

In a scenario where a patient dove head first into shallow water and is unresponsive, what vital signs would you expect?

1. Hypertensive and tachycardic

2. Normotensive and bradycardic

3. Hypotensive and bradycardic

4. Hypotensive and tachycardic

The correct answer is: Hypotensive and bradycardic

In the scenario described, where a patient has dove head first into shallow water and is unresponsive, the physiological responses of hypotension and bradycardia can be explained through the effects of possible cervical spine injury and resultant shock. When a patient experiences a significant head or neck injury, there may be neurogenic shock due to disruption of sympathetic nervous system output. This condition can lead to hypotension, as the body's ability to maintain vascular tone and pressure is impaired. Consequently, the blood pressure would be low due to reduced vascular resistance. Additionally, bradycardia can occur in conjunction with hypotension in cases of cervical spine injuries. The vagus nerve, which can be affected by such injuries, is responsible for slowing the heart rate. When the sympathetic nervous system is compromised, the body may fail to compensate for the low blood pressure with an increased heart rate, leading instead to a lower heart rate. Together, these vital signs of hypotension and bradycardia in an unresponsive patient after a high-impact diving accident align with the expected physiological responses to significant neurological trauma or shock.