Treatment is with inotropic agents. Tension Pneumothorax can mimic cardiogenic shock. A flap-valve type injury allows air to enter the pleural space, but not escape. The lung collapses and the mediastinum shifts to the opposite side. Venous return is impaired and causes a fall in the cardiac output.
Tension pneumothorax is a surgical emergency.
Diagnosis is made by the presence of respiratory distress, the absence of breath sounds, hyperresonance to percussion, and shift of the trachea to the opposite side. Perform immediate decompression with a large gauge needle and chest tube. There is no need for radiographic confirmation. Neurogenic Shock occurs with spinal cord injury, isolated head injuries do not cause shock. The major pathophysiologic abnormality is decreased systemic vascular resistance, i.e. peripheral vasodilatation.