Prehospital Trauma Life Support (PHTLS) Practice Test

Which assessment finding indicates major circulatory compromise?

1. Pale, cool skin

2. Warm, flushed skin

3. Clear breath sounds

4. Equal pupil response

The correct answer is: Pale, cool skin

The presence of pale, cool skin is a significant assessment finding indicative of major circulatory compromise. This occurs when there is insufficient blood flow to the skin, often due to conditions such as hypovolemia or shock. In a compromised circulatory state, the body redirects blood flow away from the extremities to maintain perfusion to vital organs, leading to skin that appears pale or ashen and feels cool to the touch. Warm, flushed skin typically suggests adequate circulation and blood flow, often seen in cases of fever or inflammation rather than circulatory compromise. Clear breath sounds do not relate to circulatory status; they pertain to the respiratory system's functionality. Similarly, equal pupil response indicates normal neurological function rather than any circulatory issue, as it reflects the brain's responsiveness to light and overall function rather than blood flow.