Modern concepts of traumatic shock: etiology, pathogenesis, clinics, diagnostics at the prehospital stage in everyday conditions and in case of emergency situations

The theoretical and practical issues of pathogenesis, clinic and diagnosis of traumatic shock are of paramount importance for medical personnel providing emergency medical care, especially at the prehospital
stage to victims with severe shock trauma, both in daily activities and in emergency situations. Purpose.
Review and systematization of publication in scientific medical literature devoted on the problem of etiology, pathogenesis, clinic and diagnosis of traumatic shock outside the hospital organization, including in
emergency conditions. Materials and methods. The analysis of 23 domestic and foreign materials published
in the databases eLibrary, CyberLeninka, PubMed/Medline, and Medical Planet was carried out. The search
for scientific publications was conducted from 1999 to 2024. Results. When analyzing the literature sources, it was found that among the injured, the proportion of people receiving injuries accompanied by shock
(shockogenic injuries) is about 2%, and in the event of various disasters up to 20%. At the same time, the
mortality rate for polytrauma accompanied by shock may exceed 50%. The main cause of traumatic shock
in victims is combined injuries. The most important trigger mechanism of traumatic shock is acute blood
loss, which can be visible and hidden. Acute blood loss leads to a decrease in the volume of circulating
blood, which triggers a complex cascade of responses: a decrease in venous return and cardiac output, hypoperfusion of organs and tissues, numerous metabolic disorders. The diagnosis of traumatic shock is based
on the features of its pathogenesis and is aimed at identifying hemodynamic, hemorheological, and metabolic disorders in the body of the victim. The identification of most violations requires special assessment
methods that are available only at the hospital stage. At the prehospital stage, the possibilities of diagnosing
traumatic shock are limited. Conclusion. The results of the reviews show how that the problem of traumatic shock is relevant and continues to attract the attention of researchers. Within the framework of theoretical aspects, research is continuing aimed at establishing new pathophysiological mechanisms of traumatic
shock. Clinical studies are aimed at solving numerous problems of correcting existing disorders in patients
with traumatic shock.

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