Shock - A Reality Check

It’s Monday at 5:10am, I was on my way to the gym for my jolt of morning wake up.

As I drive over, I see what looks to be an accident. I naturally slow down to pass it safely. As I get closer my spidy sense is tingling and for good reason.

A car had struck a pedestrian.

My EMR Training kicked in. Immediately, I pull the car over, make sure it is safe for me to exit my vehicle and make my way over. I don’t have any equipment with me and I’m in gym shorts and a T-shirt...

The driver of the vehicle is there apologizing to the struck pedestrian, a bystander is waving traffic away and time slows down a little.

The pedestrian is conscious and responsive, she is complaining of shoulder pain. She is trying to get up. The driver is standing over her and constantly asking her is she is ok and apologizing for not seeing her.

Could she have sat up? Likely, but upon seeing vomit on the ground next to her I asked her to stay down and stay still. A bystander who had tried several times to call 911 without getting through had gotten through finally just before I arrived and Paramedics were on their way. The bystander was mad at himself for mis-dialing the first few times.

EMS and the fire department arrived and took over, clearly the quick actions of all bystanders and the driver aided in getting the pedestrian the care she needed in a timely manor, but it was clear that all of us were in various states of “shock”.

Shock can be life threatening, therefore, we must treat everyone for shock.

A person who is ill or injured may go into shock. Shock happens when the vital organs do not get enough oxygen-rich blood. Shock is a life-threatening condition.

Be on the lookout for shock when providing care for any injury or sudden illness, or when someone has been involved in a serious incident (even if he or she is not badly injured). Shock is often caused by significant fluid loss, for example, diarrhea and vomiting. This is especially true in children, who can become dehydrated more easily.

Other causes of shock include the following:

• Significant blood loss

• Heart damage

• Extensive burns

• Infection

• Anaphylaxis

• Severe infection (e.g., septicemia)

What to Look For

The following are signs and symptoms of shock:

• Anxiety

• Cool, clammy skin

• Skin that is paler than normal

• Weakness

• Confusion

• Excessive thirst

• Rapid breathing

• Drowsiness or loss of responsiveness

• Nausea and vomiting

What to Do

The best thing you can do when a person is in shock is to call EMS/9-1-1. While you are waiting for EMS personnel to arrive, provide care (W.A.R.T.S.) by:

W: Keep the person warm

A: Monitor the persons ABC’s

R: Have the person rest and reassure them

T: Provide care for the cause of the shock

S: If needed place the person semi-prone (Recovery position)


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