Emergency Medical Technician (EMT) Intermediate Practice Exam

A trauma patient exhibits shock, jugular venous distention, and equal breath sounds. What condition is likely?

1. Pneumothorax

2. Pericardial tamponade

3. Spinal cord injury

4. Cardiac arrest

The correct answer is: Pericardial tamponade

The presence of shock, jugular venous distention, and equal breath sounds in a trauma patient strongly indicates pericardial tamponade. Pericardial tamponade occurs when fluid accumulates in the pericardial sac, exerting pressure on the heart and hindering its ability to pump effectively. This can lead to symptoms like shock due to reduced cardiac output. Jugular venous distention results from increased central venous pressure, which is common in cases of cardiac compromise, such as pericardial tamponade. The equal breath sounds across both lung fields suggest that there is no pulmonary complication, like a pneumothorax or significant hemothorax, affecting ventilation. In contrast, conditions like pneumothorax may present with unequal breath sounds depending on the size and presence of air in the pleural space. A spinal cord injury can cause shock but typically would not present with jugular venous distention unless there is significant fluid overload or neurogenic shock, which has different clinical characteristics. Cardiac arrest may not necessarily show defined jugular venous distention or equal breath sounds due to a lack of cardiac output. Thus, the specific combination of findings strongly supports the diagnosis of pericardial tamponade.