CPR and AED

Shock

Shock is a circulation problem where the body’s tissues don’t get enough oxygenated blood.

Shock is a danger because any physical injury or illness can be accompanied by shock, and it can quickly progress into a life-threatening condition. Pain, anxiety, and fear do not cause shock, but they can make it worse, or make it progress faster. This is why reassuring a casualty and making them comfortable is important.
Medical shock should not be confused with electrical shock or being shocked and surprised. Medical shock is life-threatening, as the brain and other organs cannot function properly.

The following tables provide the types, causes, and the signs and symptoms of shock. Severe shock can also result from medical emergencies such as diabetes, epilepsy, infection, poisoning, or a drug poisoning

Types and Causes of Shock
Cause Effect
Hypovolemic shock

Severe bleeding - internal or external (includes major fractures)

The loss of enough blood/fluid that there is not enough blood flow through the body to fill blood vessels.

Crush injuries

Loss of blood and blood plasma into tissues. There is not enough blood to fill blood vessels.

Severe burns

Loss of blood plasma (fluid) into tissues. There is not enough blood to fill blood vessels.
Cardiogenic shock

Heart attack/heart failure

Heart is not strong enough to pump blood effectively.
Spinal shock

Spinal cord or spinal nerve injuries

The brain cannot control the size of the blood vessels. The blood cannot get to the tissues properly.
Anaphylactic shock

Severe allergic reactions

Anaphylaxis may lead to a swelling of tissues, causing respiratory failure.

 

Signs and Symptoms of Shock

Signs

Symptoms

Skin lacks colour. The skin may look pale for lighter skin tones and grey for darker skin tones.

Restless

Blue-purple lips, tongue, earlobes, and fingernails.

Anxious

Cold and clammy skin.

Disoriented

Breathing is shallow and irregular. Casualty may be breathing fast or gasping for air.

Confused

Changes in level of consciousness.

Afraid

Weak, rapid pulse. Radial pulse may be absent.

Dizzy

First Aid for Shock

To minimize shock, perform the following steps:

  1. Give first aid for the injury or illness that caused the shock. Reassure the casualty often.
  2. Minimize pain by handling the casualty gently.
  3. Loosen tight clothing at the neck, chest, and waist.
  4. Keep the casualty warm, but do not overheat. Use jackets, coats, or blankets if you have them.
  5. Moisten the lips if the casualty complains of thirst. Don’t give anything to eat or drink.
  6. Place the casualty in the best position for their condition.
  7. Continue ongoing casualty care until handover.

This procedure for shock may prevent shock from becoming worse. Whenever possible, add these steps to any first aid you give.

Positioning a casualty in shock

Putting the casualty in the right position can slow the progress of shock and make the casualty more comfortable.

The position you use depends on the casualty’s condition. The casualty should be as comfortable as possible in the position you use.

No suspected head/spinal injury; fully conscious

Place the casualty on their back if injuries permit. Once the casualty is positioned, cover them to preserve body heat, but do not overheat.

No suspected head/spinal injury; less than fully conscious

Place the casualty in the recovery position. When there is decreased level of consciousness, airway and breathing are the priority. The recovery position ensures an open airway.

Conscious with a breathing emergency and/or chest pain

If a conscious casualty is experiencing chest pain or is having difficulty breathing, have them sit in a semi-sitting position, or any position that makes breathing easier for them.

Suspected head/spinal injury

If you suspect a head or spinal injury, steady and support the casualty in the position found. This protects the head and spine from further injury. Monitor the ABCs closely.

As injuries permit

A casualty’s injuries may not permit you to put them into the best position. Continue to support the head and neck and, if needed, use a head-tilt/chin-lift to maintain the open airway. Always think of the casualty’s comfort when choosing a position.