Whether you were the driver or a passenger in a car accident, you may experience shock as a result of the ordeal. Shock isn’t just a condition that inflicts psychological damage; it can also affect you physically, making it an issue that requires urgent medical attention. However, what if we told you that shock isn’t always immediate? In many cases, shock can be delayed. Here at AICA Conyers, we want to educate the public on why this happens and what should be done about it. After all, it could happen to anyone.
What Is Shock?
Before we can understand why shock may be delayed, it’s important to understand what shock is and what forms it may take. Officially called acute stress disorder (ASD), it is a psychological response to a frightening, traumatic, or shocking incident. It is also known as acute stress reaction, psychological shock, and mental shock. Most commonly, though, it’s just referred to as shock. Typically, it is a precursor to PTSD, and the immediate treatment of shock is vital to limiting how severe the PTSD will become later on.
As we understand it, shock tends to take one of two forms: sympathetic and parasympathetic. No matter which set of signs and symptoms of shock are displayed, both varieties require immediate medical help to mitigate the psychological impact later on, as well as to stabilize the physical health of the patient.
When excessive adrenaline and norepinephrine are released into the neural system, it results in sympathetic shock. These hormones can increase a person’s heart rate and respiration rate, dilate pupils, and conceal discomfort temporarily. This sort of ASD evolved as a survival mechanism to aid people in difficult conditions. Even in the face of serious injury, the “fight or flight” reaction may allow for momentarily increased physical strength and endurance. As a consequence, any injuries sustained will become more difficult to detect since sympathetic shock obscures pain and other important symptoms that would otherwise be obvious to the sufferer.
This response can also prolong life in situations that would seem to make living impossible. There are numerous accounts of people being cut in half and surviving long enough to receive medical intervention—fully conscious and able to speak to boot. The most famous of these cases is Truman Duncan, who managed to survive being bisected by a train.
Feeling faint and nauseated are classic signs of parasympathetic acute stress disorder. The sight of blood and gore frequently prompts this reaction, giving it the colloquial label of “squeamishness”. The body produces acetylcholine during this stress response, which slows the heart rate and can cause the patient to vomit, temporarily lose consciousness, or both. In many ways, this reaction is the antithesis of the sympathetic response in that it seems to make the patient more vulnerable rather than allowing them to escape.
Although it is unknown what evolutionary value this response has, it’s theorized that it may have allowed early humans to appear dead in order to avoid being eaten, or it may have been used to scald potential predators with stomach acid a la the vulture.
Why Is Shock Sometimes Delayed?
All things considered, it might seem odd that shock doesn’t always occur right away. After all, it’s a completely unconscious response designed to ensure survival. Why would you not experience shock after a car accident—one of the biggest life-or-death situations anyone could find themselves in?
Well, simply put, it isn’t. The shock itself is immediate, no matter which form it takes. “Delayed shock” is a misnomer to describe the delayed effects of shock or, more often than not, to describe the active effects of sympathetic shock. Sympathetic shock can often make a person act as though everything is okay following a traumatic accident, as the brain attempts to shield the victim from the immediate trauma by masking the pain of the event and preventing the victim from processing the full severity of the situation. Though this would have been handy for escaping predators, it’s less handy for getting medical help in time.
How Shock Is Treated
If you are treated at the scene of a car accident, first responders will look for a weak pulse, a rapid heartbeat, or low blood pressure. They may be able to determine that you are in shock based on your exterior symptoms and respond appropriately by separating you from any stress triggers and resuming proper blood circulation in your body. Your doctor can address the fundamental cause of your shock if you are in a stable condition and your organs are receiving adequate oxygen and blood flow. Internal injuries such as bone fractures, organ ruptures, or soft tissue tears may necessitate imaging procedures such as X-rays or CT scans.
When it comes to treating shock, it’s often done so with the prevention or mitigation of PTSD in mind. Though therapy is the most effective at achieving this in the long run, pharmaceutical methods have also been shown to reduce the likelihood of negative effects later on. Most commonly, this means utilizing prazosin—a high blood pressure medication—to reduce immediate stress and regulate the sympathetic response. On an experimental front, corticosteroids have been showing promise as a possible alternative in lab trials.
Handling the Aftermath
Once the shock passes, you’re going to be left with a lot of other stressors. For instance, the stress response that may have given you precious seconds of time may have also caused you to tell first responders that you weren’t hurt, complicating your legal situation and putting you in further danger. Your immediate injuries are a primary concern, but you may also experience long-lasting effects such as whiplash. Once you’re being treated and know what injuries you’ve sustained, one of your next steps will be to contact a car accident doctor.
At AICA Conyers, we have an array of professionals who specialize in orthopedic conditions—the most common aftereffects of a car accident. These specialists range from chiropractors to orthopedic surgeons, and they all have the common goal of helping you get back to your normal life.