During assessment of a gunshot wound to the chest, you note that the skin is pale. This finding is the result of:

• A. A critically low blood pressure.
• B. Decreased blood flow to the skin.
• C. Peripheral dilation of the vasculature.
• D. A significantly elevated heart rate.

Answer: (B)

Pallor from a chest wound assessment indicates reduced perfusion to the skin. In early shock from blood loss, the body constricts skin vessels and shunts blood toward core organs like the heart and brain. That decreased cutaneous blood flow makes the skin look pale and feel cool. While a very low blood pressure and a rapid heart rate are common in this scenario, the pallor specifically reflects decreased blood flow to the skin rather than the other factors alone. If the vessels in the skin were dilated, you’d expect warmer or flushed skin rather than pale.