You are dispatched Code 3 for a 45 year old male who has suffered significant blunt force trauma. Your primary assessment shows that your patient has mental status changes, cold and clammy skin, and increased respiratory and pulse rates. You should suspect ________ bleeding.

In this scenario, the symptoms presented—mental status changes, cold and clammy skin, elevated respiratory and pulse rates—are indicative of shock, often caused by significant internal bleeding. Internal bleeding can occur due to blunt force trauma, leading to blood loss within the body's cavities or tissues, which may not be immediately visible as external bleeding would be.

The cold and clammy skin suggests that the body's circulatory system is struggling to maintain blood flow and oxygen transport to vital organs due to the loss of blood volume, which is a critical sign of internal bleeding. Additionally, the changes in mental status often reflect inadequate perfusion to the brain as a result of compromised blood volume and pressure.

Considerations for the other types of bleeding include:

• External bleeding would be observed through visible wounds, which are not mentioned in this scenario.

• Capillary bleeding tends to be minimal and is usually associated with minor grazes and scrapes; it does not typically result in significant changes in vital signs or mental status.

• Venous bleeding, while serious, tends to cause noticeable flow of dark red blood from the veins; again, the symptoms presented point towards a deeper internal issue rather than external blood loss.

Therefore, the combination of the patient's condition strongly aligns