TAKE MEASURES TO PREVENT OR TREAT HYPOVOLEMIC SHOCK
When the casualty has received an injury that may result in shock (such as
severe external or internal bleeding or severe burns), take measures to prevent shock
from developing. Do not wait until the signs and symptoms of shock appear before
beginning to take action. The measures used to help prevent shock from occurring
are also used to treat shock once it has developed. Perform the following measures
when you suspect shock will develop or has already occurred.
a. Reassure Casualty. Reassure the casualty that you will take care of him.
This should help to calm the casualty and reduce his anxiety. Anxiety increases the
heart rate, which makes the casualty's condition worse.
b. Maintain Airway. Make sure that the casualty's airway remains open. Use
the head-tilt/chin-lift or jaw thrust, if needed. Administer oxygen if it is available.
c. Control Bleeding. Take measures to control external and internal bleeding.
d. Initiate IV. Initiate an intravenous infusion with Ringer's lactate or normal
saline to replace lost fluid. Select a large gauge (16 gauge or 18 gauge) needle.
(1) When fluid loss is due to bleeding, use small fluid bolus to return the
casualty's peripheral pulses and mental status.
When fluid loss is due to burns, compute the flow rate as shown in
e. Position the Casualty to Help Control Shock. If the casualty has not
already been placed in normal shock position (figure 7-1), place him in that position
unless his condition dictates otherwise. If the casualty is on a litter, elevate the foot of
Figure 7-1. Casualty in the normal shock position.
If the casualty has a suspected spinal injury, immobilize his head,
neck, and back using the procedures given in Subcourse MD0533,
Treating Fractures in the Field. Do not elevate his legs.