Which of the following are common signs of shock that a medic should recognize?

• A. Tachycardia, hypotension, cool or clammy skin, altered mental status, weak pulse
• B. Fever and flushed skin
• C. Rash and itching
• D. High blood pressure and warm skin

Answer: (A)

When the body can’t supply enough blood to vital organs, tissues begin to suffer from lack of oxygen and nutrients. The body tries to compensate by speeding up the heart to push more blood out (tachycardia). Blood vessels constrict to preserve core organs, which makes the skin feel cool and clammy. Reduced brain perfusion leads to changes in mental status, such as confusion or agitation, and the overall cardiac output drops, producing a weak, thready pulse. Hypotension is a common sign as shock progresses. This combination—rapid heart rate, low blood pressure, cool/clammy skin, altered mental status, and a weak pulse—best characterizes shock and is what a medic should recognize promptly.

Fever with flushed skin, rash and itching, or high blood pressure with warm skin are not typical signs of shock across its common presentations, so they don’t fit the usual perfusion-failure pattern.