Serious shock occurs as a result of severe injury to any part of the body.

l Crush injuries, fractures, burns, poisoning, and prolonged bleeding are very likely to cause serious shock.

l An interruption of breathing, from whatever cause, is usually followed by severe shock.

l Blast and concussion injuries, caused by pressure waves resulting from the detonation of high explosives in the air or underwater, may severely damage the internal organs of the body and cause extensive shock (as a matter of fact, signs of shock are sometimes the only outward indication of a blast or concussion injury).

As noted above, any damage to the body is accompanied by or followed by some degree of shock.

There are a number of factors that affect the seriousness of shock. Age, for example, is often a determining factor. Very young children and very old people do not usually have as much resistance to shock as young or middle-aged adults. Pain can produce shock or increase its severity. People who have been starved, deprived of water, or exposed to the extremes of cold or heat can go into shock very easily. Excessive fatigue can increase the severity of shock. In general, people who have any chronic illness are more likely to go into shock than healthy individuals. In addition to these factors, there are some unexplained differences between individuals in regard to their resistance to shock-an injury that might cause mild shock in one person could cause serious, perhaps fatal, shock in another.

Figure 10-41.-Symptoms of shock.

There are many different causes and types of shock. It is not within the scope of this text to identify all of them here. You should remember, however, that shock is certain to accompany or follow a serious injury and is often the most serious consequence of the injury.