A person who has suffered a serious injury is at risk of shock, a constantly worsening condition that can be described as “depletion of vital forces.”

First aid can minimize the development of shock if the possibility is recognized early. In a fully developed state of shock, minimal first aid is possible, but remains important until the victim can be transported to a medical facility.

In medical terminology, ‘shock’ does not refer to an emotional disorder, but to a physical condition: a failure of the heart to provide adequate circulation to all parts of the body. It is caused by a loss of blood fluid, usually after a serious injury.

When there is severe bleeding, the reduced volume of blood in the body results in a weakened heartbeat and an inadequate supply of oxygen and other nutrients to the tissues. In particular, the brain centers that regulate breathing, heart action, and blood pressure no longer function properly. Thus, a vicious circle is set in motion.

SHOCK TYPES

The following are the situations that can cause different types of shock:

hemorrhagic shock

also called ‘hemorrhagic shock’. This is the most common form of severe shock resulting from blood loss, such as burns/crush injuries. The bleeding can be internal or external. If the person is in a dehydrated state or is sweating profusely, it can hasten the onset of shock. This often happens if a burn/crush injury occurs in a high-temperature workplace.

Cardiogenic shock

Also called ‘cardiac shock’. It is the result of a failure of the heart to adequately pump blood to all parts of the body. Typical causes are: electric shocks, heart attacks and heart injuries. Conditions such as low blood pressure and edema of the ankles, if left untreated, can cause enough damage to cause cardiogenic shock.

neurogenic shock

Also called ‘nervous shock’. It is the result of the failure of the nervous system to control the diameter of the blood vessels. The blood vessels dilate beyond the point where the available blood can fill the new volume. Blood no longer fills the system properly, but rather pools in blood vessels in certain areas of the body.

Usually, this type of shock is due to nerve palsy caused by an injury to the spinal cord or brain. Severe blows to the abdomen can also disrupt the nerves, leading to neurogenic shock.

respiratory shock

Also called “shock lung.” This is due to a failure of the lungs to provide enough oxygen for circulation to the tissues. Be alert for broken ribs or sternum, deep chest wounds, neck/spinal cord injuries, or airway obstruction.

metabolic shock

Also called ‘bodily fluid shock’. It can occur in cases of severe diarrhea, vomiting, or polyuria (excessive urination). These conditions cause the loss of fluids from the bloodstream.

Anaphylactic shock

Also called ‘allergy shock’. This is a life-threatening reaction of the body to an allergen (something the person is extremely allergic to).

SYMPTOMS AND SIGNS

The most significant symptom of shock is:

• Weakness

Other symptoms may include:

• Nausea

• Third

• Dizziness

• Freshness

• restlessness and fear

Signs to watch out for are:

• Profuse (external) bleeding

• vomiting

• Fainting/Unresponsiveness

• fast and weak pulse

• Rapid, shallow breathing

• Marked drop in blood pressure (as low as 90/60 or less)

• Pale, moist and cool skin. often profuse sweating

• Dull eyes, dilated pupils

• General restlessness

It is important to remember that immediately after a serious injury (for example), the victim may seem tough and resilient, but the shock machinery may have been turned on inside. It may be a matter of a few minutes before it shows the typical signs, or it may take several hours.

FIRST AID FOR SHOCK

A person in shock should receive urgent medical attention. Meanwhile:

• Ensure an adequate airway (if the person is breathing) by positioning their head correctly. If he is not breathing, provide mouth-to-mouth resuscitation.

• Control bleeding. Direct pressure on the injury site is the fastest and most efficient way to do it. Don’t waste time looking for a bandage: use a finger or hand directly on the wound and hold the pressure until the bleeding stops. (Although you may be contaminating the wound, the risk of uncontrollable bleeding far outweighs that of possible infection. Loss of blood volume is particularly life-threatening for a person in shock.)

• Keep the patient warm. The goal is to keep your body temperature as close to normal as possible. If possible, remove wet clothing and wrap the patient loosely in blankets or coats. But don’t let the patient get overheated: the extra heat can draw a large volume of blood from deep within the body to the skin’s surface where it is needed for the essential organs of life. Do not move patients with head/neck/spine injuries to place a blanket under them.

• Ensure rest and position. Treat the patient where he is (except if he is in a danger zone: fire, smoke, collapsing building, etc.). The longer a patient in shock remains at rest, the better his chances of survival. Avoid rough or excessive handling, as body movement tends to aggravate impact. In particular, be careful when moving a patient who may have a fracture, especially if their back is affected. If there are severe injuries to the extremities, keep the patient on their back. If the patient is conscious but seems to have breathing or heart problems, he or she may feel more comfortable (and breathe easier) in a semi-recumbent position, with their head slightly elevated.

• Do not give anything by mouth. Do not give food/medication or even tea or coffee by mouth. The patient may vomit, in which case anything they vomit can be sucked into their windpipe and choke them.

• Reassure the patient. Reducing mental anxiety plays an important role in preventing shock. Talk to the patient with calm confidence, explaining her actions in the most reassuring way possible. Tactfully but firmly back away from any agitated or demoralizing passersby.

Finally, remember that in situations where shock is a clear possibility (such as significant blood loss), it is advisable to carry out all of the above steps, even if the patient’s condition appears fairly stable. The bottom line is: when in doubt, treat for shock.