Which finding is most indicative of hypovolemic shock in a trauma patient?

• A. Warm Flushed Skin
• B. Cool, Clammy Skin With Tachycardia and Hypotension
• C. Resting Tachypnea
• D. Normal Blood Pressure

Answer: (B)

In hypovolemic shock from trauma, losing blood lowers the return of blood to the heart, so the body activates the sympathetic system to preserve flow to vital organs. That causes peripheral vasoconstriction, which makes the skin cool and clammy, and the heart to beat faster (tachycardia) to maintain blood pressure. As volume loss progresses, blood pressure drops (hypotension). So the combination of cool, clammy skin with tachycardia and hypotension is the most telltale sign of hypovolemic shock in a trauma patient. Warm, flushed skin would suggest a different type of shock, rapid breathing alone is less specific, and normal blood pressure doesn’t fit shock as a whole, especially when other signs of hypoperfusion are present.