Shock:
How to Recognise and Provide First Aid for Shock

Shock is a life-threatening condition that occurs when the body is not getting enough blood flow, resulting in insufficient oxygen reaching the tissues and organs. Shock can develop after a severe injury, blood loss, allergic reactions, or other medical emergencies. Recognising the signs of shock and responding quickly with first aid can save a life.

What is Shock?

Shock occurs when the body’s circulatory system fails to deliver adequate blood and oxygen to the organs. This can happen for several reasons, such as heavy bleeding, heart problems, infections, or severe allergic reactions. Shock can quickly worsen if untreated and lead to organ failure or death.

Causes of Shock

Shock can result from various emergencies, including:

• Severe Blood Loss: Due to an injury, surgery, or internal bleeding.
• Heart Problems: Such as a heart attack or heart failure.
• Severe Infections (Septic Shock): When an infection spreads throughout the body.
• Severe Allergic Reactions (Anaphylactic Shock): Triggered by an allergen like food, medication, or insect stings.
• Burns: Major burns can lead to fluid loss, resulting in shock.
• Dehydration: Extreme fluid loss from diarrhoea, vomiting, or heatstroke.

Signs and Symptoms of Shock

Shock can be difficult to recognise in its early stages, but it rapidly worsens if untreated. The following symptoms may indicate someone is in shock:

• Pale, Cold, and Clammy Skin: The skin may appear unusually pale and feel cold or clammy to the touch.
• Weak, Rapid Pulse: The casualty may have a fast but weak pulse, indicating the heart is struggling to pump blood.
• Rapid Breathing: They may start to breathe quickly and shallowly.
• Dizziness or Fainting: Shock can cause light-headedness or fainting due to the lack of oxygen in the brain.
• Confusion or Anxiety: The person may seem confused, disoriented, or agitated.
• Blue Lips or Fingertips: As the body’s oxygen levels drop, the lips or fingertips may turn blue (cyanosis).
• Nausea or Vomiting: Shock can cause nausea and, in some cases, vomiting.
• Weakness or Collapse: As shock progresses, the casualty may become too weak to stand or move and may collapse.
• Thirst: The person may complain of feeling very thirsty due to fluid loss.
• Unconsciousness: In severe cases, shock can cause the person to lose consciousness.

First Aid for Shock

1. Call 999 Immediately:

• Shock is a medical emergency. Call 999 immediately for professional help.
• While waiting for help, it’s important to act quickly to prevent the casualty’s condition from worsening.

2. Lay the Person Down:

• Help the casualty to lie down on their back. If possible, raise their legs slightly (about 30cm) to encourage blood flow to the heart and brain.
• Do not raise the legs if the person has a head, neck, back, or leg injury.

3. Keep the Person Warm:

• Cover the casualty with a blanket or coat to keep them warm, as shock can cause the body temperature to drop. This helps prevent hypothermia, which can make shock worse.

4. Treat the Underlying Cause (If Possible):

• If there is heavy bleeding, apply pressure to the wound with a sterile dressing or clean cloth to control blood loss.
• For burns, cool the affected area with running water and cover it with Cling film.
• For severe allergic reactions (anaphylaxis), if the person has an auto-injector (such as an EpiPen), help them use it. Anaphylaxis can cause shock quickly, so fast treatment is essential.

5. Reassure and Monitor:

• Stay with the casualty and reassure them. Shock can cause anxiety, which may worsen their condition.
• Keep checking their breathing and pulse. If they stop breathing or become unresponsive, begin CPR immediately.

6. Do Not Give Food or Drink:

• Even though the person may feel thirsty, do not give them anything to eat or drink, as this could lead to choking or complications if they need surgery.

Specific Types of Shock

Anaphylactic Shock (Severe Allergic Reaction):

• This type of shock occurs when the body has a severe allergic reaction to a substance like food, medicine, or insect stings.
• Symptoms include difficulty breathing, swelling of the face or throat, hives, and a rapid drop in blood pressure.
• Immediate treatment with adrenaline (such as an EpiPen) is required, followed by calling 999.

Septic Shock (Severe Infection):

• Septic shock results from a widespread infection that leads to dangerously low blood pressure and organ failure.
• Signs include fever, chills, rapid heartbeat, confusion, and difficulty breathing.
• Immediate medical attention is critical, as septic shock can be life-threatening.

Hypovolemic Shock (Severe Blood or Fluid Loss):

• This occurs when the body loses a large amount of blood or fluids, leading to insufficient blood flow to organs.
• Common causes include severe bleeding from injuries, dehydration, or burns.
• Controlling bleeding and replenishing fluids are essential in preventing further complications.

Cardiogenic Shock (Heart Failure):

• This type of shock occurs when the heart cannot pump enough blood to meet the body’s needs. It can be caused by a heart attack, heart failure, or arrhythmias.
• Symptoms include chest pain, shortness of breath, and weakness. Immediate medical treatment is necessary to support the heart.

When to Seek Medical Help

Shock is always a medical emergency, and you should seek help immediately if you suspect someone is in shock. Call 999 without delay, as quick treatment is essential.

You should also seek medical attention if:

• The person is bleeding heavily and you cannot stop the bleeding.
• The casualty shows signs of anaphylaxis (severe allergic reaction).
• They experience chest pain, difficulty breathing, or sudden weakness, which may indicate a heart attack or stroke.
• The person is showing signs of confusion, unconsciousness, or a rapid decline in their condition.

Prevention Tips

• Prevent Severe Blood Loss: Treat wounds quickly by applying pressure and elevating the injured area.
• Manage Allergies: Always carry an auto-injector if you are at risk of anaphylactic shock and avoid known allergens.
• Stay Hydrated: Avoid dehydration by drinking enough water, especially in hot weather or during physical activities.
• Treat Infections Early: Seek medical advice for infections to prevent them from worsening and leading to septic shock.

Key Points to Remember

• Shock is a life-threatening condition and requires immediate medical attention.
• Keep the person lying down, warm, and calm while waiting for help.
• Do not give food or drink to someone in shock.
• Always treat the underlying cause of shock, such as heavy bleeding or an allergic reaction, if possible.