Definition of Shock

Shock is a medical condition caused by low blood pressure, the sudden loss of significant blood volume, or a lack of oxygen to the body’s organs and tissues. It is a life-threatening condition that must be treated promptly. Delaying treatment may cause the compromise of multiple organs and eventually lead to death. 

In first aid scenarios, shock is usually caused by the following:

• Bleeding
• Dehydration
• Sepsis
• Heatstroke

Signs and Symptoms of Shock

The symptoms of shock depend on the severity of inadequate tissue perfusion. The primary symptoms are the following:

1. Low blood pressure causing weak peripheral pulses. However, the first aid responder should NOT assume that the patient is not in shock if they have a good blood pressure.  Blood pressure is NOT a reliable indicator of shock!
2. Rapid heartbeat (> 100 beats per minute)
3. Confusion or agitation – a person may have difficulty following instructions, a reduced attention span, and may not even realize where they are. Some people do not respond when being talked to.
4. Lightheadedness or dizziness
5. Cool, clammy skin that may be pale, blue, or gray
6. Urinating significantly less than usual

Related Video: Understanding Shock and Recognizing the Signs

First Aid Interventions for Shock

The first aid responder must act quickly to help these patients. Instructions for responders to treat a shock patient are as follows:

• Immediately activate the emergency response system or dial 9-1-1.
• Help the person lie down and elevate their lower extremities above the level of the heart to preserve blood pressure and perfusion to the vital organs and prevent further trauma if they should faint or suddenly lose consciousness.
• If shock is caused by bleeding, immediately attempt to stop the bleeding by applying pressure to the wound.
• Cover the patient with a blanket to keep them warm.
• Stay with the patient until EMS arrives.

After calling 9-1-1, elevate the patient’s legs to preserve blood pressure and improve perfusion

Severe dehydration or sepsis can also lead to shock. Exercise and illness can cause dehydration from lack of fluid intake, vomiting, fever, and diarrhea. To prevent shock in these patients, they should slowly but consistently drink small amounts of oral rehydration salts mixed with water. In severe cases, intravenous fluid therapy is necessary.

If the person has heatstroke, the goal is first to immediately cool them down. The rescuer should move them to a shady area or inside a room with air-conditioning as quickly as possible. Ice packs can be placed under the axilla and groin areas to cool the body more quickly. The rescuer can also spray the patient with room temperature water using a spray bottle while waiting for EMS to arrive.