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Shock is a life-threatening emergency caused by disrupted blood circulation, cutting off the supply of oxygen and nutrients to cells and organs. This condition requires immediate medical attention. It is estimated that up to 20% of shock victims may die. Delayed treatment increases the risk of permanent damage and death. Anaphylaxis, severe infections, or allergic reactions can lead to shock and death if not treated promptly.
Steps
Begin Treatment
Recognize the symptoms. Before applying any treatment, it is crucial to understand what you are dealing with. Signs and symptoms of shock include:
- Cold, clammy skin that may appear pale or gray
- Sweating or moist skin
- Bluish lips and fingernails
- Rapid and weak pulse
- Fast and shallow breathing
- Dilated or constricted pupils (pupils may dilate in septic shock but constrict in traumatic shock)
- Low blood pressure
- Little or no urine output
- If the victim is conscious, they may show mental changes such as disorientation, confusion, anxiety, agitation, dizziness, lightheadedness, weakness, or fatigue
- The victim may complain of chest pain, nausea, and vomiting
- Loss of consciousness
Call 911 (or 115 if you are in Vietnam) or your local emergency number. Shock is a critical condition that requires professional medical care and hospital treatment.
- You can save the victim's life by ensuring medical help is on the way while initiating treatment.
- If possible, stay in contact with emergency services to provide updates on the victim's condition.
- Follow the instructions given by the emergency dispatcher until the medical team arrives.
Check the victim's breathing and circulation. Ensure the airway is clear, the victim is breathing, and check for a pulse.
- Observe the victim's chest for movement, and place your cheek near their mouth to check for breathing.
- Continue monitoring the victim's breathing rate at least every 5 minutes, even if they can breathe on their own.
Check blood pressure if possible. If you have a blood pressure monitor and can check without causing further harm, measure the victim's blood pressure and inform the emergency dispatcher.
Begin CPR if necessary. Only perform CPR if you have been trained. Untrained individuals may cause serious harm to the victim when attempting CPR.
- Only trained individuals should perform CPR on adults, children, and infants due to the risk of severe injury or life-threatening complications.
- The American Red Cross recently updated CPR guidelines. It is crucial that only trained individuals use the latest methods and automated external defibrillators (AEDs) if available.
Position the victim in a shock-prevention posture. If the victim is conscious and has no head, leg, neck, or spinal injuries, place them in a shock-prevention position.
- Lay the victim flat on their back and elevate their legs about 30 cm.
- Do not elevate the head.
- Do not raise the legs if it causes pain or potential injury; keep the victim lying flat instead.
Do not move the victim. Provide first aid on the spot unless the situation is dangerous.
- For safety reasons, you may need to carefully move the victim and yourself away from harm. For example, on a highway during a car accident or near a collapsing or explosive construction site.
- Do not give the victim anything to eat or drink.
Perform basic first aid for visible injuries. If the victim is injured, stop bleeding from wounds or provide initial care for fractures.
- Apply pressure to bleeding wounds and cover them with clean materials if available.
Keep the victim warm. Cover the victim with any available materials such as towels, jackets, blankets, or emergency blankets.
Make the victim as comfortable as possible. Loosen tight clothing like belts, waistbands, or any garments constricting the chest.
- Loosen collars, remove ties, and unbutton or cut tight clothing.
- Remove shoes and any tight jewelry around the victim's neck or wrists.
Monitor the victim until emergency help arrives
Stay with the victim until emergency services arrive. Do not wait to see how symptoms progress to assess the victim's condition; begin treatment and monitor their progress.
- Speak to the victim calmly. If they are conscious, talking to them can help you evaluate their state.
- Keep the emergency operator updated on the victim's level of consciousness, breathing, and pulse.
Continue treatment. Check and maintain the airway, monitor breathing, and assess circulation by checking the victim's pulse.
- Every few minutes, monitor the victim's alertness until emergency services arrive.
Prevent choking. If the victim vomits or has bleeding in the mouth and there is no suspicion of spinal injury, roll them onto their side to clear the airway and prevent choking.
- If spinal injury is suspected and the victim vomits or has mouth bleeding, clear the airway if possible without moving the head, back, or neck.
- Place your hands on either side of the victim's face and gently lift their chin, using your fingertips to open their mouth and clear the airway. Be careful not to move their head or neck.
- If you cannot clear the airway, seek help to perform the "log roll" technique to turn the victim onto their side and prevent choking.
- One person should stabilize the head and neck in alignment with the back, while another gently rolls the victim onto their side.
Treat anaphylactic shock
Recognize allergic reaction symptoms. Reactions can begin within seconds or minutes of exposure to an allergen. Symptoms of anaphylaxis include:
- Pale skin, which may also flush or develop red patches, rashes, itching, and swelling at the contact site.
- A feeling of warmth.
- Difficulty swallowing or a sensation of a lump in the throat.
- Trouble breathing, coughing, wheezing, and chest tightness or discomfort.
- Swelling of the tongue and mouth, nasal congestion, and facial swelling.
- Dizziness, lightheadedness, anxiety, and slurred speech.
- Abdominal pain, nausea, vomiting, and diarrhea.
- Rapid, weak pulse and heart palpitations.
Call 911 (the emergency number in Vietnam is 115) or your local emergency number. Anaphylaxis is a critical condition requiring immediate medical attention and may necessitate hospitalization.
- Anaphylaxis can be fatal if not treated promptly. Stay in contact with emergency services for further guidance while managing the situation.
- Do not delay calling for help, even if symptoms seem mild. In some cases, initial reactions may appear minor but can escalate to life-threatening severity hours after exposure.
- Initial reactions include swelling and itching at the exposure site. For insect stings, this occurs on the skin. For drug or food allergies, swelling typically starts in the mouth and throat, quickly leading to breathing difficulties.
Administer epinephrine. Ask the individual if they carry an auto-injector like an EpiPen. Typically, it is injected into the thigh.
- This injection delivers an emergency dose of epinephrine to slow the reaction and is often carried by those aware of their food or insect sting allergies.
- Do not assume the injection alone is sufficient to stop the reaction entirely. Continue managing the situation, including seeking medical assistance.
Speak calmly and reassure the victim. Try to identify the cause of the reaction.
- Common allergens that can trigger life-threatening anaphylaxis include bee stings, insect bites or stings (e.g., fire ants), and foods like peanuts, tree nuts, shellfish, soy, and wheat products.
- If the victim is unresponsive or unable to speak, check for medical information on necklaces, bracelets, or cards in their wallet.
- If the cause is an insect or bee sting, use a hard object like a fingernail, key, or credit card to scrape the stinger out of the skin.
- Avoid using tweezers to remove the stinger, as this may inject more venom into the skin.
Follow steps to prevent shock. Lay the victim flat on their back. Avoid placing a pillow under their head, as this may obstruct breathing.
- Do not give the victim anything to eat or drink.
- Elevate their legs about 30 cm above the ground and cover them with something warm, like a jacket or blanket.
- Loosen tight clothing such as belts, ties, buttoned pants, collars, shirts, shoes, and jewelry around the neck and wrists.
- If a head, neck, back, or spinal injury is suspected, keep the victim flat on the ground without elevating their legs.
Roll the victim onto their side if they begin vomiting. To prevent choking and maintain an open airway, roll the victim onto their side if they start vomiting or if you notice blood in their mouth.
- Be cautious to avoid further injury if a spinal injury is suspected. Ask someone to assist with the "log roll" technique, keeping the head, neck, and back aligned as much as possible.
Continue to keep the airway clear while monitoring the victim's breathing and circulation. Even if the victim can breathe on their own, check their breathing and pulse every few minutes.
- Also, monitor the victim's level of alertness every few minutes until emergency services arrive.
Begin cardiopulmonary resuscitation (CPR) if necessary. Only perform CPR if you have been trained. Untrained individuals may cause harm to the victim if they attempt CPR.
- Only trained individuals should perform CPR on adults, children, and infants due to the risk of life-threatening injuries.
- The American Red Cross recently updated CPR guidelines. It is crucial that only those trained in the latest methods and the use of automated external defibrillators (AEDs), if available, should perform these procedures.
Stay with the victim until the emergency team arrives. Continue speaking to the victim calmly, reassuring them, and closely monitoring their condition for any changes.
- Medical professionals will need you to provide your observations and the steps you took during the emergency response.
Advice
- Remember to help the victim stay calm and reassure them about what you are doing.
- Call for an ambulance as soon as possible.
- Never handle an injured person beyond your capabilities due to the risk of causing further serious injury.
- Do not perform CPR unless you have been trained.
- Continue to observe the scene to ensure safety. You may need to move the victim and yourself out of a dangerous situation.
- If you have allergies to insect stings, food, or medication, take steps to wear medical alert bracelets or necklaces, carry medical cards, and have an accessible EpiPen.
