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Paediatric First Aid Refresher Modules

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Paediatric First Aid Refresher Modules

Module 7: Shock

What is shock?

Shock is a serious and critical condition. It is defined as ‘a lack of oxygen to the tissues of the body, usually caused by a fall in blood pressure or blood volume’.

Shock is often a secondary issue the first aider needs to treat on a casualty that is suffering from 

-       bleeding severely (internal or external bleeding)

-       heart conditions

-       Significant loss of fluids – vomiting, dehydration for example

-       Burns

-       Extreme allergic reaction

-       Spinal injury

The first aider needs to be able to recognise when a casualty is experiencing shock, and treat the shock, as well as continuing to treat the cause.

Recognition - General signs of shock

The signs and symptoms that the first aider can recognise are all due to the body’s natural response to shock, which is to take blood away from ‘less important’ parts of the body (skin, stomach) and ensure the vital organs have a good blood supply and reduce the stress on the heart.

Initially, the first aider may identify -

* Pale, cold and clammy skin
* A rise in the pulse rate
* Dry mouth

As shock in the casualty worsens -

* Fast shallow breathing, leading to deep sighing breathing
* Rapid and weak pulse
* Cyanosis (blue / grey tinges to the lips and skin, especially at extremities)
* Dizziness
* Sweating
* Confusion
* Eventual unconsciousness

Treatment of shock

* Treat the cause of the shock
* Lay the casualty down. If there is no evidence of a significant lower body injury, elevate the legs


Elevate Legs
* Call 999/112 for emergency help
* Maintain the casualty’s body temperature as near to normal as possible
* Loosen tight or restrictive clothing around the neck, chest of waist
* Reassure the casualty
* Manage the scene appropriately, or take the casualty somewhere quiet
* Use the Primary Survey (DRABC) to monitor the casualty, and be prepared to resuscitate if the casualty become unconscious and stops breathing normally.

Emotional Shock

Shock can also be caused by an overwhelming emotional reaction to a situation. For example, the sight of blood, experiencing pain, witnessing something traumatic or receiving some unexpected or bad news. The first aider will recognise this in the same way as listed above and treat in the same way with the priority on lying the casualty down, raising their legs and reassuring them. The casualty should recover quickly, but if they do not or you are unsure, call 999/112 for emergency help.


A fall in blood pressure can result in a temporary reduction in the supply of blood to the brain. This can result in the casualty fainting. Things that can cause fainting include,

* Pain or a fright                                                                                                  
* Lack of food
* Stress
* Extended periods of sitting or standing
* Heat

Recognition of fainting

* The casualty may lose consciousness temporarily ad fall to the floor. They may say they feel sick, dizzy and have a stomach ache before they faint
* Pale, clammy skin
* Slow pulse
* Quick recovery

Treatment of fainting

* As with shock, lay the casualty down and raise their legs to encourage the blood to return to the vital organs
* Monitor the casualty using the primary survey (DRABC)
* Remove any sources of stress, and other people. Reassure them and encourage them to take their time before they sit up
* If they do not recover quickly, or you are in any way unsure, check airway and breathing and place them in the recovery position. Call 999/112 for emergency help

Now please complete the Confirmation of Learning Quiz If you find that you don’t know an answer do return to the text and go through the section again.

You can then check your answers here 

We hope that the information above was helpful and easy to understand – do contact us if you have a comment on the material or have a suggestion for a subject that you’d like to have us cover.

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