1. Causes and Effects of Shock - The three basic effects of shock are--
• Heart is damaged and fails to pump.
• Blood loss (heavy bleeding) depletes fluids in vascular system.
• Blood vessels dilate (open wider), dropping blood pressure to dangerous level.
2. Shock might be caused by--
• Allergic reaction to foods, drugs, insect stings, and snakebites.
• Significant loss of blood.
• Reaction to sight of wound, blood, or other traumatic scene.
• Traumatic injuries.
-- Gunshot or shrapnel wounds.
-- Crush injuries.
-- Blows to the body, which can break bones or damage internal organs.
-- Head injuries.
-- Penetrating wounds such as from knife, bayonet, or missile.
3. Signs and Symptoms of Shock - Examine the casualty to see if he has any of the following signs and symptoms:
• Sweaty but cool (clammy) skin.
• Weak and rapid pulse.
• (Too) rapid breathing.
• Pale or chalky skin tone.
• Cyanosis (blue) or blotchy skin, especially around the mouth and lips.
• Restlessness or nervousness.
• Significant loss of blood.
• Confusion or disorientation.
• Nausea, vomiting, or both.
4. First-Aid Measures for Shock - First-aid procedures for shock in the field are the same ones performed to prevent it. When treating a casualty, always assume the casualty is in shock, or will be shortly. Waiting until the signs of shock are visible could jeopardize the casualty’s life.
5. Casualty Position - Never move the casualty, or his limbs, if you suspect he has fractures, and they have not yet been splinted. If you have cover and the situation permits, move the casualty to cover. Lay him on his back. A casualty in shock from a chest wound, or who is having trouble breathing, might breathe easier sitting up. If so, let him sit up, but monitor him carefully, in case his condition worsens. Elevate his feet higher than the level of his heart. Support his feet with a stable object, such as a field pack or rolled up clothing, to keep them from slipping off (see attached figures).WARNINGS: Do not elevate legs if the casualty has an unsplinted broken leg, head injury, or abdominal injury. Check casualty for leg fracture(s), and splint them, if needed, before you elevate his feet. For a casualty with an abdominal wound, place his knees in an upright (flexed) position.
Loosen clothing at the neck, waist, or wherever it might be binding. CAUTION Do not loosen or remove protective clothing in a chemical environment. Prevent the casualty from chilling or overheating. The key is to maintain normal body temperature. In cold weather, place a blanket or like item over and under him to keep him warm and prevent chilling. However, if a tourniquet has been applied, leave it exposed (if possible). In hot weather, place the casualty in the shade and protect him from becoming chilled; however, avoid the excessive use of blankets or other coverings. Calm the casualty. Throughout the entire procedure of providing first aid for a casualty, you should reassure the casualty and keep him calm. This can be done by being authoritative (taking charge) and by showing self-confidence. Assure the casualty that you are there to help him. Seekmedical aid.
6. Food and Drink - When providing first aid for shock, never give the casualty food or drink. If you must leave the casualty, or if he is unconscious, turn his head to the side to prevent him from choking if he vomits.
7. Casualty Evaluation - Continue to evaluate the casualty until medical personnel arrives or the casualty is transported to an MTF.