This type of shock is due to an insufficient 'pump' function of the heart. In the older patient a myocardial infarction should be suspected due to cardiac hypoperfusion following major trauma or myocardial infarction may be the cause of the trauma itself. Distended neck veins may be absent in case of severe hypovolemia. ECG monitoring is essential to detect any dysrhythmias that can occur after trauma. In this situation there is a decrease in systemic vascular resistance, with a secondary reduction in circulating fluids.
Neurogenic shock is due to a loss of vasomotor sympathetic tone in spinal cord injury.
The classical picture of this type of shock is hypotension without tachycardia or cutaneous vasoconstriction. Septic Shock Is uncommon immediately after trauma. It may occur if the patient arrives at the emergency room several hours after trauma. This type of shock is more common in penetrating injury, especially of the abdomen with contamination of the peritoneal cavity by bowel contents. The signs of hypovolemic shock are usually easy to recognize when established.