Signs and Symptoms of Shock

When I’m teaching I always talk about using the ABCDE approach. The aim of this technique is to identify someone who is unwell and needs emergency assistance. What we are looking for is to identify the signs and symptoms of shock and treat the casualty to the best of our ability whilst waiting for our emergency help to arrive.

What is shock?

It’s important to understand what shock is. Often when we talk about shock we mean someone who has had an unpleasant surprise or experience. The medical term shock is defined as:-

“A lack of oxygen to the tissues of the body, usually caused be a fall in blood pressure or blood volume”

What happens when your blood pressure drops?

Initially your body will seek to maintain blood pressure through various mechanisms. It will reduce blood flow to non-vital organs eg skin and digestive system This is why people appear pale and clammy and feel nauseous or vomit. It will also reduce urine output in an effort to preserve fluid in the circulation.

What causes shock?

There are different types of shock but the most common ones are described below:-

Hypovolaemic shock

Hypo=low, vol=volume, aemic=blood; therefore this type of shock is caused by a loss of body fluids. Examples of typical causes are internal or external bleeding, diarrhoea and vomiting or burns.

Cardiogenic shock

Cardio=heart; therefore this type of shock is caused by the failure of the heart to pump correctly. Examples of typical causes are heart attack, heart failure or heart valve problems.

Anaphylactic shock

Anaphylactic shock occurs following a severe allergic reaction. Although caused by an allergic reaction it causes a drop in blood volume because fluid leaks from the blood vessels into the surrounding tissues hence the swelling; this leads to a loss of circulating volume and the small blood vessels dilate which causes the blood pressure to drop further.

Septic shock

The other cause of shock that I discuss when I’m teaching is that of ‘Septic Shock’. This occurs when someone is overwhelmed by an infection. I have written a previous blog on this subject which you can read here.

Recognising someone in Shock

Recognising the signs and symptoms of shock is key to identifying someone who needs emergency help. I’ve detailed these below in an ABCDE order. Someone may show all of these symptoms or only one or two. This is not an exhaustive list but is the main signs and symptoms we would expect to see.

Airway

Swelling around the face and airway associated with Anaphylactic shock. Noisy breathing eg stridor, wheeze.

Breathing

Fast, shallow breathing – unable to talk in sentences. Blue or grey lips or skin.

Circulation

Pale and clammy skin. Fast, weak pulse. Feeling faint. Low blood pressure. Chest pain.

Disability

Losing consciousness, drowsy, exhausted. Confusion or aggression. May become unconscious.

Exposure

Rash. Obvious signs of bleeding. Diarrhoea nd vomiting.

How to treat someone who is in Shock

The main thing to do is to try and recognise that someone is going into Shock early so that help can be called. Whilst waiting for your help to arrive these are some suggestions:-

lay the person down with legs raised
keep them warm
bring any emergency equipment you may have nearby
if you have oxygen available administer this
monitor their breathing and pulse
do not apply your defibrillator pads but be ready to resuscitate if needed
ensure 999/112 has been called
send someone to wait for and greet the ambulance

I hope you found this blog useful. You may also like these previous blogs:-

How to put someone in the recovery position

Using the ABCDE approach in Primary Care

Signs and Symptoms of Shock