Shock is a complex condition that occurs when the body can no longer deliver oxygen and nutrients to the cells and carry away the waste products of metabolism. True shock is not fainting, emotional distress or panic. Shock is a dying process and should be treated with the seriousness it deserves. Shock requires immediate emergency intervention.

The circulatory system is made up of a pump, pipes and fluid. There are three mechanisms which may cause shock. First is the failure of the pump (heart). The most common cause of pump failure is actual damage to the heart from a heart attack. The second cause of shock is inadequate fluid (blood) to carry the oxygen, nutrients and waste products. Bleeding is the most common cause of loss of fluid and can be either external or internal. The third cause of shock, and by far the least common, is the dilation or expansion of the pipes (blood vessels). A number of conditions can cause blood vessel dilation, including spinal cord injury, infection and allergic reactions.

Recognition of shock in the early stages is based on your ability to recognize and monitor a sympathetic response. Early signs of shock include a patient who seems very restless and anxious despite your attempts to calm them, skin which turns pale, cool and sweaty and a rapid pulse which becomes more difficult to feel. As shock worsens, you should expect the patient to become less and less responsive. The extent of their injuries, and the time that passes before their injuries are treated will determine how quickly they go into shock.

When trauma is involved, make certain the EMS system has been activated. Untreated shock, regardless of its cause, will progress to death. No matter what type of shock you are dealing with, the first aid treatment of shock is basically the same. Have the patient lie down and elevate their legs about 12 inches. This is called the shock position. Placing a patient in this position aids the movement of blood to the core of the body, where the majority of the body's vital organs are located.

Keep in mind, internal bleeding often escapes detection because it is not visible. Since you cannot stop internal bleeding, your only first aid treatment is to place the patient in the shock position. Help maintain the patient's body temperature by placing blankets or coats over them. If available, oxygen is an excellent adjunct to treatment. The rest of your treatment options for trauma are to keep the patient as comfortable as possible until EMS arrives. Continue to monitor changes in their level of responsiveness as well as their ABC's.