Shock following major trauma is MOST often the result of:

• A. spinal injury.
• B. long bone fractures.
• C. head injury.
• D. hemorrhage.

Answer: (D)

Blood loss from injuries is the primary driver of shock after major trauma. When vessels or organs bleed, the circulating blood volume drops, reducing venous return to the heart (preload) and lowering stroke volume and cardiac output. The body tries to compensate with faster heart rate and peripheral vasoconstriction, but ongoing hemorrhage overwhelms those mechanisms and tissue perfusion falls, leading to shock.

This is more common than other shock types after trauma because significant bleeding can occur from solid organ lacerations, pelvic fractures, or major vessel injuries, producing a large volume deficit. In contrast, neurogenic shock from spinal or head injuries and obstructive shock from tension pneumothorax or tamponade occur, but these are less frequent overall in blunt trauma. Long bone fractures can bleed, but the amount is typically less than bleeding from abdominal or pelvic sources.

So, the best answer reflects that hypovolemic shock from hemorrhage is the most frequent consequence of major trauma, guiding the emphasis on rapid bleeding control and urgent transport.