Shock & Resuscitation
Shock questions dominate NREMT medical and trauma scenarios. The exam wants to see you recognize compensated shock before the blood pressure ever falls.
EMT · AEMT · Paramedic
The four categories
Hypovolemic, cardiogenic, distributive (septic, anaphylactic, neurogenic), and obstructive. Every scenario answer depends on which category you identify.
Recognizing compensated shock
Anxious or restless patient with tachycardia, tachypnea, pale/cool/diaphoretic skin, and a narrowing pulse pressure — before the systolic BP falls. Trust the skin and mental status over the number.
Field management
Order matters — the NREMT loves questions where the wrong step is skipping hemorrhage control to start an IV.
- Control external hemorrhage first
- Airway, high-flow oxygen, ventilatory support if needed
- Position supine, prevent hypothermia with blankets
- IV/IO access and fluids per protocol (permissive hypotension in bleeding trauma)
- Rapid transport to the appropriate center
Frequently asked
- Why is blood pressure a late finding in shock?
- Healthy adults compensate with vasoconstriction and tachycardia. By the time the systolic BP drops, they've usually lost 30–40% of circulating volume.
- How much fluid do I give in septic shock?
- 30 mL/kg crystalloid bolus is the standard starting point when hypotension is present, unless local protocol says otherwise.
Test yourself
Practice on this topic.
Free 10-question sample or build a custom quiz on shock & resuscitation.