Shock

When seriously injured (and to some extent with minor injuries and illness), the body initiates shock, a natural response that pools blood into one or more vital organs. Shock reduces the blood reaching other body tissues, which may deprive them of oxygen. Severe, sustained shock can cause permanent disabili­ties, including death, so begin treating shock as soon as possible.

Signs and symptoms of shock include shallow breathing, labored breathing, gasping and noisy breathing. The patient may be pale, and have moist clammy skin. You may find the patient's pulse weak and rapid. The patient may be anxious and despite the injury, may be restless and not want to lie down. Nausea, vomiting, thirst, light-headedness and confusion also indicate shock.

Treating shock begins with primary assessment, which itself manages more serious conditions that lead to shock, such as cardiac arrest or severe bleeding. Once you've completed these steps, maintain your circle of care and take these steps to reduce shock:

1. Maintain the patient's body temperature. If necessary, put a blanket under and over the patient.
2. Keep the patient lying down.
3. Elevate legs If' suspected internal/external bleeding. Do not elevate if suspected head, neck, back or leg injuries.
4. Don't give the patient anything to eat or drink.
5. Summon professional emergency medical care if no one has done so already
6. monitor the patient, maintaining the circle of care until help arrives.

Basic Life Support (BLS)

If in your primary assessment you discover that the patient isn't breathing, and/or has no pulse, the patient requires basic life Support. For a no breathing patient, you'll begin rescue breath­ing. If the patient also has no pulse, you'll perform CPR for artificial circulation. Any trained person can perform BLS without sophisticated medical equipment, and it has proved effective in maintain­ing an restoring life in many instances. However, you need to keep in mind that BLS is time critical.

When either the respiratory or circulatory system fails, oxygen stops reaching the body. Most body tissues can endure a reasonable period without oxygen but the brain can’t. Without oxygen, you can expect brain damage in four to six minutes. After six minutes without oxygen, brain damage is very likely. After 10 minutes, the brain suffers irreversible brain damage (Note: One noted exception may be a person immersed in extremely cold water. There have been cold water drowning accidents in which the patients were revived after more than 30 minutes without appar­ent brain damage).

Ideally, you want to begin BLS as soon as you recognize the need for it, and continue it until the patient is under professional emergency medical care. The realities of diving mean you can't always, (for example, effective CPR isn’t possible in the water - more about this is Chapter Six), but when a diver needs BLS, you want to begin BLS as soon as possible.