Emergency Medical Technician (EMT) Intermediate Practice Exam

During the reassessment of a patient with a head injury, which finding is the earliest indicator of increasing intracranial pressure?

1. Headache

2. Pupil dilation

3. Decreasing level of consciousness

4. Vomiting

The correct answer is: Decreasing level of consciousness

The earliest indicator of increasing intracranial pressure in a patient with a head injury is a decreasing level of consciousness. This change can occur due to the pressure exerting an influence on the brain, affecting its function and the patient’s responsiveness. As intracranial pressure rises, it may disrupt normal brain activity and lead to alterations in consciousness before other physical symptoms manifest. While other signs, such as pupil dilation or headache, are significant and can indicate a progression in the patient’s condition as pressure continues to increase, they typically occur after there is a measurable change in the level of consciousness. Vomiting can also be a consequence of increased intracranial pressure and is more likely to signify advanced or severe pressure changes rather than being an early sign. Monitoring the level of consciousness is, therefore, a vital procedure in the management of head injuries, as early recognition allows for timely medical intervention.