One of the major items considered in a survival system is the first aid kit. Many recognize the reality that, if in a survival situation, no matter the cause, there is a real risk of injuries. Many of these injuries can be minor. Twisted ankles, small cuts or burns and bruises are sure to be a part of the survival experience. These are handled rather easily with basic knowledge that all but everyone possesses. Many concerned with survival have kits that can handle much more than this, though. They have sucking chest wound seals, tourniquets, splints, and a whole host of additional supplies for major traumas. All of those injuries require different supplies and different actions, but they have one thing in common; Shock.
Shock is a last ditch effort by the body to stay alive. The hope is that by shutting down “non-essential” operations, vital organs and functions may continue until the body heals. At first, this is fine. Not digesting food for a while until an illness passes is okay. Shunting blood away from a few fingers to keep the vital organs warm and perfused is good. The problem comes when the body starts to sacrifice major organs, such as the kidneys, to keep the heart and brain alive. As bad as this can get (death), a first responder can stop shock in its tracks and give the victim a longer window to receive definitive care.
The first task is to identify that a person is in shock. Depending on the nature of the injury, there are different forms of shock. To keep it simple for a first responder, the focus of signs and symptoms will be narrowed to:
- Low blood pressure – Without a blood pressure cuff, you can check the carotid for a pulse to be sure the heart is beating. After you find that, search for a radial pulse. If the radial pulse cannot be found, this is a good indication that the victim has low blood pressure.
- Altered mental status – If the victim is acting strange, is lethargic, has abnormally delayed responses to simple questions (who they are, where they are, what happened to them, and what month is it), they are probably in shock. This is mostly effective for persons known or suspected to have normal function and mentation when not injured or ill.
- Agitation or anxiety – To be upset after an injury is normal. To be afraid that an injury may mean the loss of an appendage or proper function of something is normal. To be afraid and unable to explain the fear, to be inconsolable, and to be excessively restless are not an indications of being hurt. These are signs of shock.
- Very sweaty skin – If the amount of sweat is much more than the environment calls for, the victim is in severe distress.
- Dry skin – If the person could have a spinal injury, the ability to sweat may be absent. If everyone else is sweating in the desert summer and the victim is not after falling off a roof, they could have a broken neck or back and are going in to shock.
- Very slow or very fast heart rate – The normal heart rate is 60-100 beats per minute. If it is much slower than that, suspect shock. To be faster than that at a rate of 105 or 110 after an injury does not mean shock on its own, however, a rate of 120 or a fast rate with other signs is a good indication of shock.
- Cool to the touch – Except spinal injuries that lead to shock, patients in shock will be cool to the touch.
The ability to identify a person in shock is great. Now, do something about it. First and foremost, it must be considered that the spine may be injured. If there is reason to believe that the neck or spine has been significantly injured, it is important to keep the neck and back in a straight line add limit how much the victim is moved. Rapid and excessive movements should only be done if the victim will soon die where they are, such as in the case of fire moving towards them. After protecting the spine, the major cause of the shock needs to be treated as best as possible and as quickly as possible. Now, the shock itself must be treated. This is done by keeping the victim warm and lifting the legs (may not be possible for abdominal or leg injuries) to keep the blood near the core of the body. If oxygen is available, apply it at a rate of 10-15 liters be minute with a mask or at 6 liters per minute through a nose tube. If the patient is able to hear and/or speak, reassure them. Remind them to breathe normally, that help is on the way, and that they are doing well/you are proud of their strength, whatever seems to make them feel safer and more relaxed.
Without advanced medical training and the required tools, any person in shock will not do well and time is a major factor. A person with some basic knowledge and tools, however, can add minutes back to the clock and keep the victim alive long enough to reach proper care. In addition to keeping the person alive, a rescuer’s efforts to treat a victim for shock could mean the difference in the person keeping a limb or not, how long the victim will be in rehabilitation, if they become brain dead or make a full recovery.
Once a person enters shock, it becomes an uphill battle to save their life. Because of that, it is important to assess for signs of shock early on and to repeat them often. The sooner shock is discovered and managed; the easier it is to control.
Disclaimer: The content in this article is the opinion of the writer and does not necessarily reflect the policies or opinions of US Patriot Tactical.
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