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Shock represents a critical medical emergency triggered by disruption of regular blood circulation, resulting in the deprivation of oxygen and vital nutrients to cells and organs. Immediate medical intervention is imperative. Statistical estimations suggest that up to 20% of individuals experiencing shock may succumb to it. Delayed initiation of treatment escalates the risk of permanent organ damage and fatality. Anaphylaxis, severe infections, or allergic reactions can also induce circulatory shock and potential fatality if not promptly managed.
Procedures
Commencing Treatment
Identify the indications. Prior to administering any form of treatment, it's crucial to recognize the symptoms. Symptoms of shock encompass the following:
- Cool, clammy skin with a pale or grayish hue
- Excessive sweating or moist skin
- Bluish lips and fingernails
- Swift and feeble pulse
- Rapid and shallow respiration
- Enlarged or contracted pupils (pupils may dilate in septic shock, but can constrict in traumatic shock)
- Reduced blood pressure
- Scanty or absent urine output
- If the individual is conscious, they may exhibit an altered mental state such as disorientation, confusion, anxiety, agitation, dizziness, lightheadedness, or sensations of faintness, weakness, or fatigue
- The individual may report chest discomfort, nausea, and episodes of vomiting
- Subsequent loss of consciousness may occur
Contact 911 or your local emergency services number. Shock constitutes a medical emergency, necessitating skilled medical attention and hospitalization.
- You can potentially save the individual's life by ensuring paramedics are en route while you begin treatment.
- If feasible, remain on the line with the emergency services dispatcher to provide continual updates regarding the individual's condition.
- Adhere to the dispatcher's instructions until emergency medical assistance arrives.
Assess breathing and circulation. Ensure the airway is unobstructed, confirm the person is breathing, and check for a pulse.
- Observe the rise and fall of the person's chest, and place your cheek near the person’s mouth to detect breath.
- Continuously monitor the person’s breathing rate, at least every 5 minutes, even if they are breathing autonomously.
Evaluate blood pressure if feasible. If blood pressure measurement equipment is available and can be used safely, monitor the person’s blood pressure and relay it to the dispatcher.
Initiate CPR if necessary. Administer CPR only if you are trained to do so. Improper CPR attempts by untrained individuals may cause serious harm.
- Only individuals with proper training should administer CPR to adults, children, and infants, due to the risk of severe and life-threatening injury.
- The American Red Cross has recently updated protocols for CPR administration. It is imperative that only individuals trained in the new methods, and in the use of an AED if available, undertake these procedures.
Position the individual in the shock position. If the individual is conscious and free from head, leg, neck, or spine injuries, proceed to place them in the shock position.
- Lay the individual on their back and elevate their legs approximately 12 inches (30 cm).
- Do not elevate the head.
- If elevating the legs causes discomfort or potential harm, refrain from doing so and leave the individual in a flat position.
Avoid relocating the individual. Attend to the individual at their current location unless the immediate vicinity poses hazards.
- For safety considerations, you might need to cautiously move both the individual and yourself away from potential dangers. This could involve scenarios like being situated on a busy highway after a car accident or near an unstable structure at risk of collapse or explosion.
- Do not allow the individual to consume food or beverages.
Administer basic first aid for visible injuries. In cases of trauma, it may be necessary to halt bleeding from a wound or administer first aid for a fractured bone.
- Apply pressure to any bleeding wounds and use clean materials to dress them if available.
- Wear gloves when exposed to blood or other bodily fluids to protect against potential bloodborne pathogens.
Ensure the individual remains warm. Use available materials such as towels, jackets, blankets, or first aid blankets to cover them.
Prioritize the individual's comfort. Loosen any tight clothing items, such as belts, snug waistbands, or constrictive garments around the chest area.
- Loosen collars, remove neckties, and unfasten or remove snug attire.
- Relax footwear and remove any tight or restrictive jewelry from the wrists or neck if applicable.
Monitoring the Individual Until Assistance Arrives
Remain by the individual's side until assistance arrives. Do not delay in assessing the individual's condition, initiating treatment, and monitoring their progress or deterioration..
- Engage in calm conversation with the individual. If they are conscious, conversing can aid in ongoing evaluation of their condition.
- Continue providing updates to the dispatcher regarding the individual's level of consciousness, breathing, and pulse.
Carry on with your treatment. Ensure the airway remains clear, monitor breathing, and assess circulation by checking the pulse.
- Regularly assess consciousness level until paramedics arrive.
Prevent choking incidents. If the individual vomits or experiences oral bleeding without suspected spinal injury, turn them onto their side to maintain airway clearance and prevent choking.
- If spinal injury is suspected and the individual is vomiting or bleeding from the mouth, attempt to clear the airway without moving their head, back, or neck.
- Place your hands on each side of the individual’s face, gently lift their jaw, and use your fingertips to open their mouth to clear the airway. Be careful not to move their head and neck.
- If unable to clear their airway, seek assistance for a log-rolling maneuver to turn them onto their side to prevent choking.
- One person should support the head and neck, maintaining alignment with the back, while another gently rolls the injured individual onto their side.
Managing Anaphylaxis
Identify symptoms of an allergic reaction. Symptoms typically manifest within seconds or minutes of allergen exposure. They include:
- Pale or flushed skin, hives, itching, and swelling at the site of exposure.
- Feeling of warmth.
- Difficulty swallowing, sensation of a lump in the throat.
- Difficulty breathing, coughing, wheezing, chest tightness or discomfort.
- Swelling of the tongue and mouth, nasal congestion, facial swelling.
- Dizziness, lightheadedness, anxiety, slurred speech.
- Abdominal pain, nausea, vomiting, diarrhea.
- Palpitations, weak and rapid pulse.
Contact 911 or your local emergency services number. Anaphylaxis constitutes a medical emergency, necessitating skilled medical attention, and potentially hospitalization.
- Anaphylaxis can result in fatality if not promptly treated. Remain connected with emergency services for further guidance while administering treatment.
- Do not delay in seeking emergency medical assistance, even if symptoms seem mild. In some instances, the reaction may initially appear mild but escalate to a severe and life-threatening stage hours after exposure.
- Initial symptoms involve swelling and itching at the exposure site. For insect stings, this occurs on the skin, while for food or drug allergies, swelling typically begins in the mouth and throat, hindering breathing.
Administer epinephrine injection. Inquire if the individual possesses an epinephrine autoinjector, such as an EpiPen. Inject the shot into the thigh.
- This injection delivers a life-saving dose of epinephrine to mitigate the reaction and is commonly carried by individuals with known food and bee sting allergies.
- Do not assume the injection alone will entirely halt the reaction. Proceed with additional treatment, including seeking emergency medical aid.
Engage in calm, reassuring dialogue with the individual. Attempt to ascertain the cause of the reaction.
- Common allergens triggering life-threatening anaphylactic reactions include bee or wasp stings, insect bites or stings like fire ants, and certain foods such as peanuts, tree nuts, shellfish, soy, or wheat products.
- If the individual cannot communicate, check for a medical alert necklace, bracelet, or wallet card.
- If the reaction stems from an insect or bee sting, remove the stinger using a firm object like a fingernail, key, or credit card.
- Avoid using tweezers to remove the stinger, as this may inject more venom into the skin.
Take measures to prevent shock. Lay the individual flat on the ground or floor, avoiding placing a pillow under their head to prevent breathing interference.
- Refrain from offering food or drink to the individual.
- Elevate their feet approximately 12 inches (30 cm) off the ground and cover them with a warm garment such as a coat or blanket.
- Loosen any constrictive clothing items such as belts, neckties, buttoned pants, collars, shirts, shoes, and neck or wrist jewelry.
- If there's suspicion of head, neck, back, or spinal injury, refrain from elevating their legs and allow them to remain flat on the ground or floor.
Turn the individual onto their side if vomiting occurs. To prevent choking and maintain their airway, roll the individual onto their side if they begin to vomit or if blood is observed in the mouth.
- Exercise caution to avoid exacerbating potential spinal injuries. Enlist assistance to gently log-roll the individual onto their side while maintaining alignment of the head, neck, and back.
Continue ensuring an unobstructed airway and monitoring breathing and circulation. Even if the individual is breathing independently, regularly assess their breathing rate and pulse every few minutes.
- Additionally, monitor the individual’s level of consciousness every few minutes until emergency responders arrive.
Initiate CPR if required. Administer CPR only if you have received proper training. Attempting CPR without training can result in severe harm to the individual.
- Only individuals with proper training should perform CPR on adults, children, and infants, as there is a risk of serious and life-threatening injuries.
- The American Red Cross has recently introduced new CPR protocols. It is crucial that individuals trained in these new techniques and in the use of an AED, if available, take the lead in administering CPR.
Stay with the individual until the arrival of paramedics. Maintain a calm and reassuring demeanor while conversing with the individual, continuously monitor their condition, and remain vigilant for any changes.
- Medical personnel will require updates from you regarding your observations and the actions you have taken to address the medical emergency.
Recommendations
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Do not attempt CPR unless properly trained.
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Avoid exceeding your capabilities when providing assistance to an injured individual to prevent further harm.
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Continue to assess the safety of the surroundings. You may need to relocate the individual and yourself to avoid potential dangers.
