Circulatory shock is a life-threatening medical emergency. As a First Aider, it’s important to be able to recognise the signs and symptoms of shock. These can include a fast heart rate (in the early stages of shock) or a slow heart rate (in the late stages of shock), sweating, cold skin, dry mouth, aggressive behaviour, confusion, nausea and vomiting, loss of consciousness, and seizures or fits.
What is shock?
Shock, often referred to as circulatory shock, is a dangerous, life-threatening condition in which a casualty experiences low blood flow – and therefore low oxygen delivery – to the organs, cells, and tissues of the body. Circulatory shock is one of the most common causes of death for critically ill people.(Circulatory shock should not be confused with emotional shock, which is a psychological response to a stressful or traumatic event.)
What are the different types of shock?
In First Aid, we focus on four main types of shock:
- Hypovolemic shock
- Cardiogenic shock
- Neurogenic shock
- Anaphylactic shock
Hypovolemic shock
Hypovolemic shock is the most common type of medical shock and is characterised by low blood volume in the body. This is caused by a severe loss of blood or fluids, for example through severe internal or external bleeding (haemorrhaging). In children, hypovolemic shock is often caused by vomiting or diarrhoea. Other causes include serious burns, environmental exposure, excessive exercise, and inadequate fluid intake.
Cardiogenic shock
The heart is the muscle responsible for pumping (circulating) blood around the body. Cardiogenic shock is when the heart fails to pump properly. As a result, the body’s organs and tissues cannot receive oxygen-rich blood. Cardiogenic shock is often caused by damage to the heart muscle, for example as a result of a serious heart attack (myocardial infarction).
Neurogenic shock
Neurogenic shock is caused by damage to the nervous system due to a brain or spinal cord injury, resulting in low blood pressure. When this happens, the blood vessels dilate and blood pools instead of circulating. Damage to the spinal cord is usually caused by trauma, such as falls, accidents, gunshots, assaults, etc.
Anaphylactic shock
Anaphylactic shock is caused by a severe, systemic allergic reaction. People may be allergic to bee or wasp stings, peanuts, shellfish, certain medications, or other substances. Anaphylactic shock occurs when a casualty is exposed to an allergen, triggering the body to release a large amount of chemicals. This causes the blood vessels to dilate and leak fluid, the airways to narrow, and the casualty’s blood pressure to drop.
What are the signs and symptoms of shock?
The severity of the casualty’s condition (whether they are in the early stages of shock or the late stages) will determine which signs and symptoms of shock they present with.
Early-stage signs and symptoms of shock:
- Fast heart rate
- Sweating and cold skin
- Dry mouth
- Aggressive behaviour
- Confusion
- Nausea and vomiting
Late-stage signs and symptoms of shock:
- Slow heart rate
- Loss of consciousness
- Seizures/fits
What is the first aid treatment for shock?
First aid treatment for shock consists of following the primary and secondary survey treatment process, calling the emergency services as soon as possible, and administering Basic Life Support if necessary.
Treat any obvious bleeding by applying bleeding control techniques (apply direct pressure to the wound, apply a pressure bandage, elevate and immobilise the limb, and apply a tourniquet if necessary).
A casualty in shock may be aggressive and confused or, in the later stages, unconscious. Don’t restrain the casualty, but keep them lying horizontally with their legs slightly raised if possible. If the casualty is unconscious, place them in the lateral recovery position and monitor their airway while you wait for the emergency services to arrive.
Keep the casualty warm by covering them with a blanket and try to keep them calm. Monitor and record the patient’s heart rate and other vital signs and record any changes in values.
Safety first
- Ensure safety to yourself, the scene, bystanders, and the casualty.
Primary survey
- Follow the treatment process for the primary survey:
- D – Danger
- R – Response
- A – Airway
- B – Breathing
- C – Call and Circulation
- D – Defibrillation
Ensure that the emergency services are on their way. If the casualty is not breathing or has no pulse, begin cardiopulmonary resuscitation (CPR) immediately.
Secondary survey
- Follow the treatment process for the secondary survey:
- S – Signs and symptoms
- A – Allergies
- M – Medications
- P – Past illnesses
- L – Last oral intake
- E – Event leading up to the illness
Use the secondary survey to attempt to determine why the casualty is in shock. If they have allergies, were they exposed to the allergen, causing anaphylactic shock? If so, use the casualty’s auto-injector immediately while waiting for emergency services to arrive.
Learn the first aid treatment for shock and other medical emergencies in an accredited first aid course.
When a casualty is experiencing a life-threatening condition like circulatory shock, the quick actions of a trained First Aider can greatly increase the casualty’s chances of survival. Our accredited first aid courses teach the treatment for shock, heart attacks, strokes, burns, fractures, wounds, head and spinal injuries, and much more. Contact us to find out more or request a quick quote here.