Shock & Airway Management
Shock Management
Shock is the body’s reaction to decreased blood flow to one or more organs throughout the body. Ino order for the body to function properly, it must receive a constant supply of oxygen from blood. When there’s not enough oxygen being delivered to replace the amount of oxygen consumed by the body, shock may occur.
Shock can advance quickly into a life threatening emergency. It’s critical for you to recognize the signs and symptoms of shock as early as possible. Prompt treatment can prevent the casualty condition from worsening.
Signs and Symptoms of Shock
You may not immediately see all of the signs and symptoms of shock in a casualty. Early recognition and treatment are crucial for recovery. The following are the signs and symptoms of shock in the order they may appear:
-Evidence of obvious and excessive bleeding
-Anxiety, restlessness, combativeness
-Confusion/disorientation
-Pale, cool, clammy skin
-Weak and rapid pulse
-Excessive thirst
-Nausea and vomiting
-Rapid, shallow breathing
-Unconsciousness
-Bluish/ashen/gray skin (around lips and nail beds)
-Dilated pupils
Treating for Shock
Immediately treat all life threatening injuries first and then treat for shock. Sometimes the signs and symptoms of shock are obvious; however, sometimes they are not (such as when the casualty is unconscious). This is why you MUST treat for shock even if the casualty does not display the signs and symptoms of shock. Failure to treat a casualty suffering from shock could result in irreversible medical conditions or even death.
1: Treat all life-threatening injuries first! Ensure the casualty is breathing. If not, immediately open the casualty’s airway. Next, control the casualty’s bleeding, if needed.
2: Loosen any binding clothing, including boots/shoes. Tight clothing can interfere with the blood circulation. When loosening clothing around wounds, be careful of inflicting further injuries and pain to the casualty
3: Shock normally causes a decrease in the body’s temperature. Casualties must be kept warm and dry to prevent additional medical issues and to prevent shock from worsening. If the casualty is on the ground, ensure adequate material (e.g., blanket or jackets) is placed under and over the casualty.
4: DO NOT allow the casualty any food, doing so may delay further medical treatment (I.e. surgery). You may provide the casualty sips of water. DO NOT allow them to consume large volumes of water, doing so may delay further medical treatment.
5: Annotate the care provided on the Casualty Card. The casualty is now ready for transport unless further medical assessment is required.
Note: Always talk to the casualty. Your words and actions can reassure them and reduce their anxiety. Tell the casualty that you’re here to help. Be confident in your abilities.
Remember: Maintain Airway, Control Bleeding, Loosen Tight Clothing, Prevent Loss of Body Heat, Keep Them Calm, Request Medical Assistance
Airway Management
One of the initial steps in assessing any casualty is to determine if he or she has an open airway. An unconscious casualty has no control over his or her muscles, including the muscles that control the tongue. Airway obstructions often occur when the relaxed tongue falls into the back of the throat and disrupts breathing. If this occurs, it’s imperative that you open the airway quickly.
Airway management is a TOP PRIORITY when performing SABC. Simply put, if there’s no airway then there is no breathing. No breathing means that neither the lungs nor the rest of the body receives oxygen. The bottom line is if a casualty stops breathing, then death will occur.
You have the ability and the tools necessary to open the casualty’s airway and save a life. First, check the airway by looking, listening, and feeling.
Look: at the chest to see if it rises and falls.
Listen: for the sound of air moving in and out of the nose or mouth.
Feel: for air against your cheek from the nose or mouth
Airway Management Techniques
If you determine the airway is not open, there are two methods to open an airway
-Head-Tilt/Chin-Lift Technique
-Jaw Thrust Technique
Head-Tilt/Chin-Lift
The head-tilt/chin-lift technique provides for the maximum opening of the airway.
1: Kneel beside the casualty’s shoulder to determine if he is unresponsive.
2: Place one hand on the casualty’s forehead, and place the fingertips of the other hand under the bony aspect of the casualty’s chin.
3: Gently tilt the casualty’s head by applying downward pressure on the forehead while gently lifting the chin upward. This maneuver straightens the windpipe to allow air movement in and out of the lungs. Ensure you DO NOT apply too much pressure to the chin area when tilting the chin upward.
4: The mouth SHOULD NOT be closed as this may block the airway. If needed, the thumb may be used to depress the victim’s lower lip slightly to keep the victim’s mouth open
5: Treat for shock. Annotate care provided on the Casualty Card. The casualty is now ready for transport unless further medical assessment is required (i.e. treat for bleeding).
Jaw-Thrust Technique
The jaw-thrust technique is used to open the airway of an unconscious casualty that you suspect has a head, neck, or spinal injury. This technique minimizes movement of the head and neck to prevent further injury. If the casualty sustained an injury from a fall, you would automatically assume that a head, neck, or spinal injury has occurred.
1: Establish unresponsiveness. Take a position at the top of the casualty’s head, resting your elbows on the ground on either side of the head.
2: Carefully reach forward and gently place one hand on each side of the casualty’s lower jaw, at the angle of the jaw.
3: Stabilize the casualty’s head between your forearms. Using your fingers, gently grasp the angle of the lower jaw and lift it upward.
4: You may need to retract the casualty’s lower lip with your thumb to keep the mouth open. DO NOT tilt or rotate the casualty’s head. Doing so may cause further injury to the casualty’s spinal cord.
5: If you suspect a head, neck, or spinal injury, immobilize the casualty using any means possible. Items you can use are rolled up towels, heavy books, etc…
6: Treat for shock. Annotate care provided on the Casualty Card. The casualty is now ready for transport unless further medical assessment is required.
