Emergency Medical Technician (EMT) Intermediate Practice Exam

A construction worker pinned between a truck and a loading dock presents with upper torso and facial cyanosis. What must you be prepared for when treating this patient?

1. Mild hypotension after liberation

2. Severe hypotension once he is freed

3. Stable vital signs upon release

4. Respiratory distress improvement

The correct answer is: Severe hypotension once he is freed

Severe hypotension once the patient is freed is a critical concern in this scenario. When a patient is pinned for an extended period, especially under significant pressure, they may experience a condition known as compartment syndrome or even a cardiovascular response to the stress and trauma. The pressure can lead to vasoconstriction and further complications that can result in sharp decreases in blood pressure once the pressure is relieved. Releasing the pressure allows blood to flow back to affected tissues, which can result in a rapid drop in cardiac output and instability in blood pressure, especially if the patient was under continued demand with inadequate blood flow. Therefore, it is vital to be prepared for the potential for severe hypotension right after liberation. In contrast, while mild hypotension could occur, severe hypotension poses a far more significant risk to the patient's stability. Stable vital signs upon release is unlikely due to the physiological changes caused by immobilization and the sudden release of pressure. Lastly, respiratory distress improvement may occur, but the emphasis on hypotension highlights the more immediate and critical risk to address during treatment.