The term shock has a variety of meanings. In medicine, it refers to a collapse of the body’s cardiovascular system which includes an inadequate supply of blood to the body’s tissues. Shock stuns and weakens the body. When the normal blood flow in the body is upset, death can result. Early recognition and proper first aid may save the casualty’s life.
Causes and Effects
There are three basic mechanisms associated with shock. These are—
- The heart is damaged and fails to work as a pump.
- Blood loss (heavy bleeding) causes the volume of fluid within the vascular system to be insufficient.
- The blood vessels dilate (open wider) so that the blood within the system (even though it is a normal volume [the casualty is not bleeding or dehydrated]) is insufficient to provide adequate circulation within the body.
Shock may be the result of a number of conditions. These include—
- Allergic reaction to foods, drugs, insect stings, and snakebites.
- Significant loss of blood.
- Reaction to the sight of a wound, blood, or other traumatic scene.
- Traumatic injuries, such as—
- Crush injuries.
- Blows to the body (which can cause broken bones or damage to internal organs).
- Penetrating wounds.
Signs and Symptoms of Shock
Examine the casualty to see if he has any of the following signs and symptoms:
- Sweaty but cool skin (clammy skin).
- Weak and rapid pulse.
- Paleness of skin (in dark-skinned individuals they may have a grayish look to their skin).
- Restlessness, nervousness.
- Loss of blood (bleeding).
- Confusion (or loss of awareness).
- Faster-than-normal breathing rate.
- Blotchy or bluish skin (especially around the mouth and lips).
- Nausea and/or vomiting.
First Aid Measures for Shock
In the field, the first aid procedures administered for shock are identical to procedures that would be performed to prevent shock. When treating a casualty, assume that shock is present or will occur shortly. By waiting until actual signs and symptoms of shock are noticeable, the rescuer may jeopardize the casualty’s life.
Position the Casualty. (DO NOT move the casualty or his limbs if suspected fractures have not been splinted.
- Move the casualty to cover, if cover is available and the situation permits.
- Lay the casualty on his back.
NOTE: A casualty in shock from a chest wound or one who is experiencing breathing difficulty, may breathe easier in a sitting position. If this is the case, allow him to sit upright, but monitor carefully in case his condition worsens.
- Elevate the casualty’s feet higher than the level of his heart. Use a stable object (Backpack or rolled up clothing) so that his feet will not slip off
WARNING: DO NOT elevate legs if the casualty has an unsplinted broken leg, head injury, or abdominal injury.
WARNING: Check casualty for leg fracture(s) and splint, if necessary, before elevating his feet. For a casualty with an abdominal wound, place his knees in an upright (flexed) position.
- Loosen clothing at the neck, waist, or wherever it may be binding.
- Prevent chilling or overheating. The key is to maintain body temperature. In cold weather, place a blanket or other like item over him to keep him warm and under him to prevent chilling. However, if a tourniquet has been applied, leave it exposed (if possible). In hot weather, place the casualty in the shade and protect him from becoming chilled; however, avoid the excessive use of blankets or other coverings.
- Calm the casualty. Throughout the entire procedure of providing first aid for a casualty, the rescuer should reassure the casualty and keep him calm. This can be done by being authoritative (taking charge) and by showing self-confidence. Assure the casualty that you are there to help him.
- Seek medical aid.
Food and/or Drink. When providing first aid for shock, DO NOT give the casualty any food or drink. If you must leave the casualty or if he is unconscious, turn his head to the side to prevent him from choking if he vomits.
Evaluate Casualty. Continue to evaluate the casualty until medical personnel arrives or the casualty is transported to a medical facility.
The information on this page has been adapted from the U.S. Army Field Manual 4-25.11, First Aid