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First Aid/Shock
Reference material by Wikibooks contributors. This retains its source identity and is not 411 news reporting.
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
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
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
thumb|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:
Warmth
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
Should a patient become unconscious, confirm that an ambulance has been called, and take the following steps:
Reassess the ABCs airway, breathing, circulations. Should any change occur, compensate with required treatment. (exception: Patient goes into cardiac arrest, begin CPR cardiopulmonary resuscitation.)
As airway takes priority over other treatment, you should place them in the recovery position in order to ensure a patent airway.