Emergency Medical Technician (EMT) Intermediate Practice Exam

In a case of 'pump failure' with a blood pressure of 80/40 mm Hg, what is the recommended initial treatment?

1. Administer a vasopressor

2. Give a 20 mL/kg crystalloid fluid bolus

3. Send the patient for immediate surgery

4. Provide high-flow oxygen

The correct answer is: Give a 20 mL/kg crystalloid fluid bolus

In cases of 'pump failure', characterized by a significantly low blood pressure such as 80/40 mm Hg, the primary issue often involves inadequate circulation and volume within the cardiovascular system. The recommended initial treatment is to provide a 20 mL/kg crystalloid fluid bolus. This approach is crucial because it aims to increase the intravascular volume, thereby improving venous return to the heart and enhancing cardiac output. Administering crystalloid fluids can effectively help in restoring blood pressure and improving perfusion to vital organs. The rationale behind preferring a fluid bolus in this situation lies in the physiological need to correct inadequate circulation before resorting to other interventions. While vasopressors can be essential in managing hypotension associated with septic shock or significant pump failure, they are generally used after initial fluid resuscitation. High-flow oxygen is also important in cases of hypoxia but does not directly address the underlying hemodynamic instability. Surgical intervention may be necessary in certain cases but is not the immediate step in managing acute hypotension unless indicated by specific findings in diagnostics. Thus, initiating treatment with fluid resuscitation aligns with standard protocols in managing hypovolemic or cardiogenic shock.