Shock First Aid

What is shock first aid?

Shock first aid is lifesaving care that can help a person who’s in shock or at risk of going into it. Shock happens because of a widespread lack of oxygen in your body. Without oxygen, your body’s systems start shutting down. If they don’t get their oxygen supply back quickly enough, the affected cells will start dying. And if that lasts too long, it can cause permanent damage or even death.

IMPORTANT: Shock is a life-threatening medical emergency. It needs immediate medical care. If you suspect that you or someone you’re with is going into shock, call 911 (or your local emergency services number) immediately.

Types of shock

There are four main types of shock. The type you have can sometimes determine which shock first aid measures you need. The four types of shock are:

• Cardiogenic shock: This means your heart isn’t pumping blood effectively. That can happen when something interferes with your heart’s pumping action or disrupts blood flow through your heart. An example would be a heart attack or an irregular heart rhythm (arrhythmia).
• Distributive shock: Normally, your body automatically adjusts blood vessel width to manage blood pressure. Distributive shock means your circulatory system can’t do that properly. This can happen if you have conditions like sepsis or anaphylaxis from an allergic reaction.
• Hypovolemic shock: This happens when you don’t have enough liquid blood volume to keep it circulating. That can result from severe blood loss. It can also happen if you don’t have enough fluid overall in your body, like when you’re dehydrated.
• Obstructive shock: This means something is blocking circulation. That can be something pressing on your heart directly, like with cardiac tamponade, or on one of the nearby great vessels.

Sometimes, you can also have more than one of the above forms at the same time. Experts call that mixed shock.

Shock symptoms

People who are in shock or close to it can have the following symptoms:

• Feeling dizzy or lightheaded, or being confused
• Fainting/passing out or having deeper forms of unconsciousness like coma
• Excessive sweating (diaphoresis)
• Pulse that’s weak and/or fast, or not having a pulse
• Having pale, cool or clammy skin
• Fast and/or shallow breathing or not breathing at all
• Fever, chills or shivering

What is the first aid treatment for shock?

If you think someone’s in shock, the very first thing you should do is make sure you’re both out of danger. If you’re not safe, move both of you to safety however you can.

Once you’re safe, get help. That means calling 911 or your local emergency services number, or sending someone else to get help. If there’s no one else to send for help, do what you can to help the person in shock first. Don’t leave them until they’re as stable as you can make them, and even then, only leave them as a last resort.

You should also remember:

• Don’t wait to call for help. Always assume a person in shock is going to get worse.
• Don’t give the person anything by mouth, including food or drink, especially if they’re unconscious.
• Don’t move the person if they might have a head, neck, back or spine injury (unless not moving them would put them in more danger). Also, avoid moving them if they have any visibly broken bones. And even if they don’t have a dangerous injury, try to move them as little as possible.

Unless you’re a trained medical professional, you can’t diagnose shock yourself. That means you can only react to:

• What a person in shock can tell you
• What you can see
• Any obvious physical signs, like not breathing or not having a pulse

The treatments for shock can vary slightly depending on which type of shock you’re experiencing. But when someone’s unconscious, all shock treatments start with the ABCs. Those letters stand for:

• Airway: Make sure their airway is open and clear, and tilt their chin up slightly to keep it open.
• Breathing: Check if they’re breathing or not.
• Circulation: Make sure blood can circulate.

It’s absolutely critical to confirm these in that order. That’s because you can’t survive more than a few minutes if you aren’t breathing, and you can’t breathe if your airway is blocked.

If they’re breathing

If the person is breathing, look for any potential threats to their circulation. If they have severe bleeding, try the following measures (if one doesn’t work, move on to the next):

1. Apply direct pressure: Put a bandage on the wound and press directly on the wound. Don’t hesitate to press hard, even if it’s painful. Maintain that pressure until first responders arrive.
2. Pack the wound: Use gauze or bandage material and push it into the wound. Then, apply direct pressure on top of the wound itself. In an emergency, a towel or T-shirt works, too. Stopping the bleeding is more important than worrying about infection right now.
3. Use a cinching method like a Spanish windlass (for wounds on limbs only): Tie a bandage loosely around the wound and insert a rod or stick just underneath. Wind the object so the bandage cinches tightly atop the wound. Once the bleeding stops, tie the winding object in place.
4. Use a tourniquet (for wounds on limbs only): This stops bleeding by cutting off blood flow to the injury. You should only use this as a last resort or if you need to quickly stop bleeding so you can do other lifesaving care like CPR.

If they’re not breathing

If the person isn’t breathing, the circulation step often means starting CPR. But if the person has severe bleeding, you have to stop the bleeding immediately so they’ll have as much blood left in their body to circulate as possible. Once you stop the bleeding, you can then start CPR.

Keep doing CPR until you can get an automated external defibrillator (AED) and try to use it. If you don’t have or can’t use an AED, continue CPR until help arrives. Remember, CPR is very tiring. Swap out with others who can also do CPR when you need to rest.

Other things you can do to help someone in shock

Some other key actions you can take to help someone in shock or in danger of going into shock are:

• Keep them warm: Use blankets or jackets to cover them.
• Elevate their feet by about 12 inches (unless they might have a head, neck, back, hip or leg injury): This helps push blood toward their torso and head. That can make it easier to circulate blood to critical organs like the brain. Don’t elevate their head.
• Treat specific causes: If a person is in shock because of an allergic reaction and anaphylaxis, see if they have something like an epinephrine auto-injector.
• Use the rescue position if needed: If they start to vomit, drool or bleed from their mouth, put them in the recovery position. Keep their back, neck and head aligned, and gently roll them onto their side. Stretch out their arm nearest the ground and use it to support their head.