Prehospital Trauma Life Support (PHTLS) Practice Test

What is one of the earliest signs of hypovolemic shock?

1. Hypotension

2. Bradycardia

3. Anxiety

4. Reduced urine output

The correct answer is: Anxiety

Anxiety is often one of the earliest signs of hypovolemic shock for several reasons. When a person begins to experience significant blood loss and the body's compensatory mechanisms are activated, the sympathetic nervous system responds. This response is characterized by an increase in heart rate and blood pressure initially, but as the condition progresses, anxiety can manifest as a result of the body's declining perfusion and the realization of distressing physical changes. On the other hand, hypotension typically occurs after more significant fluid loss has taken place and often represents a late sign of hypovolemic shock. Bradycardia is less common in hypovolemic shock, as a typical response would be tachycardia due to compensatory mechanisms aiming to maintain adequate circulation. Reduced urine output is often a sign of more severe shock; as the kidneys receive less perfusion due to decreased blood volume, this happens later in the pathophysiological process. Understanding that anxiety can stem from early physiological stress responses helps in recognizing this sign in a prehospital setting, prompting quicker interventions to support the patient before more critical symptoms develop.