First Aid/Shock

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Shock can refer to a range of related medical conditions in which the victim's heart, lungs and blood cannot deliver oxygen to the body properly. Shock is not a diagnosis or condition, it is always a symptom of a larger problem, and is a medical emergency that requires immediate attention. One should never confuse true shock with a feeling of extreme surprise  – one does not lead to the other.

Key types of shock[edit | edit source]

Hypovolemic shock
caused by the rapid loss of blood from the blood vessels, either inside and outside the body
Cardiogenic shock
caused by failure of the heart to move blood adequately. This is typically caused by damaged heart muscle due to a heart attack
Distributive shock
caused by enlargement of the blood vessels so that the pressure within them drops
Anaphylactic shock
caused by an allergic reaction which forces fluid out of the blood vessels
Septic shock
caused by a severe infection which poisons the blood vessels, causing them to enlarge
Neurogenic shock
caused by a spinal cord injury, preventing the brain from communicating with blood vessels
Obstructive shock
caused by a blockage in a blood vessel, preventing blood from flowing past it.

Regardless of type, the goals of the layperson rescuer are the same: prevent blood loss and preserve body temperature.

Recognition[edit | edit source]

The sooner a shock is recognized, the better the victim's outcome will be. Although signs of shock can range greatly, some common signs are:

Early Phases
  • A fast pulse
  • Pale, cool, clammy skin
  • Sweating
  • Flushed face
  • Anxiety or agitation
Developing phase
  • Ashen or blue skin on lips and nail beds
  • Cold, damp skin
  • Weakness and dizziness
  • Nausea and possibly vomiting
  • Thirst
  • Rapid, shallow breathing
  • Weak, very rapid, "thready" pulse
  • Confusion, disorientation
Advanced phases
  • Lack of pulse in wrists or feet
  • Restlessness and aggressiveness
  • Yawning and gasping for air
  • Unconsciousness
Final phase
  • Multiple organ failure
  • Cardiac arrest

Treatment[edit | edit source]

A healthcare provider checks the carotid pulse of a victim in the recovery position.

The most important treatment for shock of any variety is to try to maintain the blood flow to the body's vital organs (brain, heart, and lungs). To do this, lie the patient flat on the floor and raise their legs about 6–12 inches (15–30 cm) off the ground. Do not incline the victim's head, chest, or pelvis, as this brings no improvement and can cause harm.

Other important factors in the treatment of shock can be remembered by the simple mnemonic WARTS:

ABCs (Airway, Breathing, Circulation)
Rest and Reassurance
Treatment of underlying cause
Semiprone position (only if the victim would like to assume semiprone position; if unconscious do it)

Unconscious patients[edit | edit source]

Should a patient become unconscious, confirm that an ambulance has been called, and take the following steps:

  • Reassess the ABCs. Should any change occur, compensate with required treatment. (exception: Patient goes into cardiac arrest, begin CPR.)
  • As airway takes priority over other treatment, you should place them in the recovery position in order to ensure a patent airway.
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