NREMT Paramedic Practice

Which of the following is a sign of cardiogenic shock?

1. Elevated blood pressure

2. Warm, dry skin

3. Cool, clammy skin

4. Bradycardia

The correct answer is: Cool, clammy skin

Cool, clammy skin is a key sign of cardiogenic shock due to the body’s response to inadequate cardiac output. In cardiogenic shock, the heart's ability to pump effectively is compromised, leading to reduced blood flow and oxygen delivery to vital organs. This inadequate perfusion causes peripheral tissues to become cool and can lead to clammy skin as a result of sympathetic nervous system activation, which constricts blood vessels to prioritize blood flow to essential organs. In contrast, elevated blood pressure is not typically observed in cardiogenic shock, as the condition often leads to hypotension due to the heart’s impaired pumping ability. Warm, dry skin would suggest adequate perfusion and may indicate conditions like septic shock, where blood vessels are dilated. Bradycardia can occur in certain situations but is not a classic sign of cardiogenic shock; instead, tachycardia is more common as the body attempts to compensate for decreased cardiac output. Understanding these signs helps in the early recognition and management of cardiogenic shock.