# Treating Shock -- Time 4:43

John:

Ok, if you don't take care of the bleeding problem somebody can go into
shock. Help me define shock in a very simplistic manner that I can
understand. Ok, loss of body fluid. Does it mean necessary that they
loose it because they cut themselves? No, is fainting a form of shock?
Bloods not getting where? Brain, heart, lungs, circulation, very
important. Somebody who's about to faint looks like what? Pail, sweaty.
What do we call that when you touch them and there, diaphoretic means
sweaty, but more importantly they present as being cool to the touch and
wet, right. What do you think is the first thing you should do for
somebody who's about to faint? First of all you lay them down. Why? A
lot of times the injury that results from the fall is a lot worse then
whatever caused the faint to begin with. So you lay them down. What is
the appropriate shock position? Cory come help me for a second will ya.

All right, what is the appropriate shock position? Well first of all
Cory was about to faint. Come lay over here. So the first thing we did
is we laid him down. The proper shock position includes lifting their
feet. A training note, there are two things that will so quicker than
anything else in a disaster event. The first is stretchers, the second
is blankets. I made the mistake for a little whiles of demonstrating the
shock position by placing the blankets underneath the feet. Blankets do
not belong underneath people's feet. They belong on top of them. But the
shock position does include elevating the feet. How high do you elevate
somebody's feet? Above the level of the heart. It will say six to ten
inches, the idea is you elevate the feet to get this blood circulation;
the veins have the ability or the capacity to pull blood. So what you do
is use gravity to move that stagnating blood down to the mainstream
circulation, the heart, the lungs and the brain. Remember that when you
treat somebody for shock you also have to pay attention to the operative
words their body temperature, you want to maintain their body
temperature. And use a little bit of common sense. Were going to
maintain his body temperature but in Idaho in February we evacuate this
building, lets use New York City, we take somebody let's say from one of
your building in New York City in February, we take folks out we line
them all up, we lay them down we elevate their feet and we put them on
the sidewalk and them we put a blanket over the top of them, have we
done anything for those people? Where's their body temperature going or
where's their body heat going? Right down into the concrete. What about
in Phoenix in July? You take folks out you lay them down on the black
top you elevate their feet and you wonder why you can't get them to sit
still, cause you're burning them. Think about what you're putting
patients on top of. The operative words here are to maintain body
temperature. That's the key thing. Does that make sense? When people are
learning this they will ask you certain questions one argument that I
heard once that I didn't quite understand is a doctor was telling me
that I could end up having reverse compression upon the knees if I ended
up leaving patients in this position. The shock position works well to
maintain people in whatever position you can and I would think that
reverse compression on the knees would be a problem later on, unless of
course you're a cowboy. All right thanks Cory.