Now let's cover shock. You know, the interesting thing about shock,
which is pretty much defined by saying "it's a failure of the body to circulate oxygenated blood to cells."
The interesting thing about it is that everybody who dies, eventually dies from some form of shock.
So, when we're talking about emergency first aid, it's one of the things we'll always be watching for,
along with airway, breathing, circulation, bleeding control.
Right after we get into that circulation aspect, we think about shock symptoms.
Shock is sometimes misunderstood as shock like psychogenic shock or psychological emotional shock.
Like "Ahhh," scared or surprised. But that's not the kind of shock we're talking about.
We're talking about one of the many forms of shock --
Forms meaning we could have spinal shock, caused secondary to a spinal cord injury;
cardiogenic shock, primarily from pump failure;
hypovolemic shock, from loss of fluids or blood;
anaphylactic shock, which is primarily caused from a severe allergic reaction.
And those are the main types of shock we'll see out in the environment.
The symptoms are pretty much going to be about the same, though.
Decreased level of consciousness, anxiety, chilled and cold, pale, clammy,
poor capillary refill. You pinch the nail bed, it usually takes 2-3 seconds to refill.
If it takes more than that, we're probably showing a delay in capillary refill,
which could be an early sign of shock. The rapid breathing, rapid pulse -- signs of shock.
Many times, we don't know the reason why they're going into the shock,
unless there's an obvious external trauma.
But if it's an internal injury, if it's a brain injury, a heart injury, we won't know exactly why they
are going into shock. We'll just know that they are showing the symptoms of shock.
And when they do, we're going to treat it the same way.
If we haven't already called 911, we're going to make sure our scene is safe,
gloves are on, CPR shield is available, and activate emergency medical services.
Then, treat the primary causes of that shock. If they're unresponsive, we're still going to check to
see if they're breathing. If they are breathing, fantastic!
Now we know we can move to the secondary issues -- bleeding control, shock management,
fracture management. In this case, he is breathing, he's pale, cool, sweaty, delayed capillary refill.
No obvious signs of external bleeding that would cause us any problems. We can now treat for shock.
Primary treatment for shock is laying them down.
After we've managed airway, breathing, and compressions, and it's not an issue,
we want to make the patient as warm as possible. Why?
Keeping the body warm helps it compensate for shock.
If it doesn't have to vasodilate in his extremities, that helps it to shunt the blood
to the main areas of the body -- brain, heart, the different vascular organs
that need to be fed with oxygenated blood to stay alive.
Keeping them warm helps that. So, when we do our demonstration, we'll show
how we're going to cover the patient with a warm blanket to help them with this issue.
And then, if we don't suspect any kind of spinal cord injury or hip injury or long bone fracture,
we're going to elevate the legs, making sure to put the box or object to keep their legs elevated
above their heart, somewhere around their knees so that we don't hyperextend their knees.
By elevating the legs, keeping them warm, laying them down,
and then re-assessing them for breathing and circulation, and controlling any other
external injuries, like external bleeding, is how we're going to help this person
combat the effects of shock and give them a second chance at survival.
The scene is safe, my gloves are on, my CPR shield is available.
Sir, sir, are you alright, are you okay? He appears to be breathing but he's not responsive.
You, in the plaid shirt, go call 911 and come back. I might need your help.
He does appear to be breathing, but he looks pale, cool, sweaty,
low capillary refill, slow capillary refill, and he's unresponsive. I think he might be suffering from
shock. I'm going to elevate his legs. Does anyone know how he got hurt?
Any back injuries? We find out that we don't suspect any neck or back injuries.
I'm going to elevate the legs, being careful not to hyperextend the knees.
Sir, can you hear me? Can you hear me? He still appears to be breathing.
I do not see any external hemorrhaging or bleeding that needs to be controlled.
I'm just going to maintain re-assessment every couple of minutes and make sure
that if there's any problems, I treat them. And wait for EMS to arrive.