The word shock can be used in a range of ways, but when used in a first aid context it describes a physical condition that results from a loss of circulating body fluid. It should not be confused with emotional shock that might occur, say, when a person has received bad news (although the external signs are very similar).
What happens in cases of shock
A severe loss of body fluid will lead to a drop in blood pressure. Eventually the blood's circulation around the body will deteriorate and the remaining blood flow will be directed to the vital organs such as the brain. Blood will therefore be directed away from the outer areas of the body, so the casualty will appear paler than previously and the skin will feel cold and clammy. As blood flow slows, so does the amount of oxygen reaching the brain.
The casualty may appear to be confused, weak and dizzy, and may eventually deteriorate into unconsciousness. To try to compensate for this lack of oxygen, the heart and breathing rates both speed up, gradually becoming weaker, and may eventually cease.
Potential causes of shock include: severe internal or external bleeding; burns; severe vomiting and diarrhoea, especially in children and the elderly; problems with the heart.
First Aid Treatment
Keep the casualty warm but do not allow her to get overheated. If you are outside, try to get something underneath the casualty if you can do so easily. Wrap blankets and coats around her, paying particular attention to the head, through which much body heat is lost.
Maintain a careful eye on the casualty's airway and be prepared to turn her into the recovery position if necessary, or even to resuscitate if breathing stops. Try to clear back bystanders and loosen tight clothing to allow maximum air to the casualty.
Keep the casualty still and preferably sitting or lying down. If the casualty is very giddy, lay her down with her legs raised to ensure that maximum blood and therefore maximum oxygen is sent to the brain.
Reassure the casualty but keep your comments realistic. Do not say that everything is going to be fine when it is obvious that there is something seriously wrong. Let the casualty know that everything that can be done is being done and that help has been called for. If she has other worries then try to resolve these.
Treat the cause of the shock and aim to prevent further fluid loss.
Ensure that appropriate medical help is on the way.
Signs and symptoms
Shock kills, so it is vital that you can recognise these signs and symptoms. With internal bleeding in particular, shock can occur some time after an accident, so if a person with a history of injury starts to display these symptoms coupled with any of the symptoms of internal bleeding, advise her to seek urgent medical attention, or take or send her to hospital.
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