Shock Recognition And First Aid Management
The Australian and New Zealand Committee on Resuscitation (ANZCOR) make the following recommendations for Shock Recognition First Aid Management.
1. Control any bleeding promptly.
2. Send for an ambulance.
3. Reassure and constantly re-check the person’s condition for any change.
4. Keep the person warm.
What Is Shock And Why Can It Be Deadly
Shock is a life-threatening condition that may become critical brought on by the sudden drop in blood pressure and blood flow through the body.
Shock occurs when the closed blood circulation system is compromised. The organs and tissues do not get sufficient oxygen-rich blood and nutrient delivery to function correctly, or an artery may have been severed, causing a bleed out that reduces the amount of blood able to circulate with each beat.
On average, the adult human has between 4.5-5.5 litres of blood, that equates to approximately 10 % of their total body weight.
The lack of oxygenated blood causes life-threatening organ failure that progressively shuts down all of the organs and, if left untreated, can result in total body failure and death.
Any seriously ill or injured person is at risk of developing shock. Shock has several main categories: distributive shock, cardiogenic shock, hypovolemic shock, obstructive shock, and anaphylactic shock.
What Causes Shock In Humans
Some conditions that may induce shock include:
· Loss of circulating blood volume
· Spinal Cord injury
· Heart failure
· Severe bleeding (internal and / or external) corrupting the flow of blood
· Major or multiple fractures or major trauma
· Severe burns or scalds
· Severe diarrhoea and vomiting
· Severe sweating and dehydration
Cardiogenic Shock (Cardiac causes):
• Heart attack
• Abnormal heart rhythm.
Distributive Shock (Abnormal dilation of blood vessels):
• Severe infection (sepsis)
• Severe allergic reactions (anaphylaxis)
• Severe brain / spinal injuries
• Fainting (generally short-lived).
Obstructive Shock (Blockage of blood flow in or out of the heart):
• A punctured lung causing increased pressure in the chest, reducing the return of blood to the heart, also known as a tension pneumothorax.
• A severe injury to the heart with weak heart muscle (cardiomyopathy) or blood around the heart reducing blood return to the heart, known as cardiac tamponade.
• A blood clot in the lung (pulmonary embolus).
• Compression of the large abdominal veins by the uterus in pregnancy.
How Do I Recognise When Someone Is In Shock
Early recognition of a seriously ill or seriously injured person should alert the responding First Aider to the potential risk of the patient developing onset shock.
The symptoms, signs and rate of onset shock vary widely depending on the nature and severity of the underlying cause. Shock is a condition that may be difficult to identify in the early stages. It is wise to treat for shock as there may be a delayed onset for some time after the initial injury has been treated in some patients.
Symptoms Of Shock May Include:
• Sudden drop in body temperature
• Ashen or extremely pale face
• Feeling cold, shivering or chills.
• Extreme discomfort or pain
Signs Of Shock May Include
• Collapse into lasting unconsciousness or fainting with rapid recovery to a conscious state.
• Rapid breathing
• Initial rapid pulse that may weaken or slow to the point of difficult detection via external pulse points.
• High fever resulting in Hyperthermia
• Abnormally low temperature resulting in hypothermia
• Cool, sweaty skin that may appear pale or discoloured
• Skin rash
• Confusion or agitation leading to a dazed, fixed staring state and possible wandering without direction or purpose.
• Decreased or deteriorating level of consciousness and responsiveness
• Decreased urine output
Management Strategy For Treating Shock
1. Ensure the safety of all at the scene
2. Lie the person down. If unconscious, place the person in the recovery position left side down where possible.
3. Control any bleeding promptly.
4. Send for an ambulance.
5. Administer treatments relevant to the cause of the shock.
6. Administer oxygen if available and trained to do so.
7. Maintain body temperature (prevent hypothermia).
8. Reassure and constantly re-check the person’s condition for any change.
9. If the person is unresponsive and not breathing normally, follow the Basic Life Support DRSABCD protocols.
Positioning Of People With Shock
If possible, and the person is conscious and alert, lie the person down rather than sitting them upright but do not try to prevent them if they wish to remain seated or become agitated. For people in shock who are lying on their back with no evidence of trauma, the use of passive leg raise (PLR) may provide a transient improvement.
Place in the recovery position and monitor while keeping warm the unconscious people with no apparent trauma and not in cardiac arrest.
For unconscious, unresponsive people in cardiac arrest or presenting with obstructed breathing, commence CPR protocol.
Lay them flat on their back. Clear the airway and begin to give CPR in the ratio of 30 compressions to 2 rescue breaths. Each compression should be approximately 5cm deep and at the ratio of between 100-120, compression per minute, or two per second for as long as physically possible or until emergency medical care arrives.
First Aid Course Experts
Taking a First Aid course sounds like something expensive and time-consuming, which was true in the past. However, times have changed, and the means of delivering the course content has also changed.
A basic First Aid course will set you back around $100 and take 6 hours to complete on average.
Test your current First Aid skills and knowledge by taking our FACE Quiz and then read up on a wide range of topics to further improve your First Aid knowledge in advance of your course, starting on our FACE Blog page.