Emergency Medical Technician (EMT) Intermediate Practice Exam

In a traumatic incident, if a patient shows signs of shock without obvious external trauma, where should you suspect bleeding?

1. Legs

2. Abdominal cavity

3. Chest cavity

4. Head

The correct answer is: Abdominal cavity

When a patient presents with signs of shock but has no apparent external trauma, internal bleeding becomes a primary concern. The abdominal cavity is particularly significant in this context because it houses several major blood vessels and organs that can be susceptible to injury in traumatic incidents, even when there are no visible soft tissue injuries on the exterior. In cases of blunt trauma, organs such as the spleen or liver can be lacerated or ruptured, causing substantial internal bleeding. This bleeding may not be immediately visible due to a lack of external wounds, especially in scenarios such as motor vehicle accidents or falls, where the impact can affect the abdomen without skin breach. As a result, the presence of shock—indicated by signs such as pale skin, rapid heartbeat, or altered mental status—can suggest that significant blood loss is occurring internally. In contrast, while there can be bleeding in the chest cavity or from injuries to the limbs or head, these cases typically present with more observable signs of trauma, making them less likely to manifest solely as shock without external evidence. Therefore, in the absence of visible injuries, the abdominal cavity is the most plausible source of hidden bleeding in this situation.