Emergency Medical Technician (EMT) Intermediate Practice Exam

Which vital sign change is most often associated with increased intracranial pressure?

1. Hypotension

2. Bradycardia

3. Fever

4. Hyperventilation

The correct answer is: Bradycardia

Bradycardia is commonly associated with increased intracranial pressure (ICP) due to the Cushing's reflex, which is the body's response to severe brain injury or increased ICP. When the pressure inside the skull rises, it can compress areas of the brain responsible for autonomic functions, including heart rate regulation. As ICP increases, the body may respond with a drop in heart rate as a compensatory mechanism aimed at maintaining cerebral perfusion despite the elevated pressures. In contrast, while hypotension, fever, and hyperventilation might occur in various medical conditions, they are not specific indicators of increased ICP in the same direct manner as bradycardia. Hypotension may indicate shock or other systemic issues, while fever could indicate infection or other inflammatory processes. Hyperventilation is often a response to metabolic or respiratory conditions, reflecting an attempt by the body to regulate carbon dioxide levels, rather than a direct consequence of elevated ICP. Therefore, bradycardia is the vital sign change most closely linked with increased intracranial pressure, making it the correct answer in this context.