Shock

Clinical shock is a medical condition that is much more serious than the general emotional shock which someone may sustain when they witness or are involved in a minor road traffic collision.

To function normally, the organs need sufficient blood pressure (perfusion pressure) to maintain blood flowing through them to deliver oxygen and other nutrients. If that pressure fails, then the organs cannot work properly. In a contact sport setting, this can be due to:

1. Not enough blood or fluid in the circulation (most commonly due to bleeding – haemorrhagic shock).
2. non- haemorrhagic causes of shock:
   1. Heat failure (cardiogenic),
   2. build up of pressure in the pleural cavity resulting in pressure on the great veins (Tension Pneumothorax)
   3. A spinal cord injury interrupting the nerve supply that normally constricts the arteries to support the blood pressure. Hence, they dilate and blood pressure falls (neurogenic shock).
   4. overwhelming inflammatory response to infection resulting in peripheral vasodilatation, fluid redistribution and reduced central circulation (Septic Shock)
   5. an overwhelming inflammatory response to an allergen resulting in peripheral vasodilatation and capillary membranes becoming leaky, resulting inleading to soft tissue swelling oedema and a significant reduction in central circulation. (anaphylactic shock).

Blood loss and haemorrhagic shock is far more common than the other causes of shock. The fundamental difference between these is that in haemorrhagic shock there is not enough blood in the circulation. Consequently, there may be confusion from the brain not functioning correctly or the casualty may feel faint due to low blood pressure.

REMEMBER THAT CONCUSSION IS A MORE COMMON CAUSE OF CONFUSION THAN SHOCK.