SHOCK PROTOCOL

Version May 20, 2022

🩸 Hemorrhage — Check firstMake sure there is no uncontrolled external hemorrhage before any other intervention.

🧊 Suspected internal hemorrhageApply cold to the site of the presumed internal hemorrhage.

🫀 Risk of cardiac arrestCheck vital signs frequently. Be vigilant for the risk of cardiac arrest.

📟 Pulse oximetry — UnreliableDue to poor blood pressure, the extremities may be cold and distort the reading. Do not rely on this result.

🧠 Cerebral hypoxia — AgitationPatients with cerebral hypoxia may become agitated. Maintain calm and surveillance.

🤮 Projectile vomitingIn cases of major head trauma, patients may have projectile vomiting. Prevent aspiration.

🩸 Check for hypoglycemiaCheck for the possibility of a hypoglycemic diabetic problem.

🚫 Nothing by mouthDo not give anything to drink or eat to a victim in shock.

PROTOCOL — SHOCK

Recognized signs — Shock

💓 Rapid & weak pulse

🫁 Rapid & shallow breathing

🧊 Cold & clammy skin · pallor

🧠 Confusion · agitation · anxiety

🩸 Control any active external hemorrhage
Apply the hemorrhagic trauma protocol if necessary

📟 Initial pulse oximetry reading if available
⚠ Do not rely on it if extremities are cold — poor blood pressure

💨 Administer high-concentration O₂
100% O₂ mask if available

👔 Loosen clothing
Collar, belt, undergarments

🦺 Leave in position found
Maintain cervical immobilization

🌡 Cover the victim with a warm or aluminum blanket
Prevent hypothermia — do not overheat

📊 Reassess vital signs (ABC) frequently
Be vigilant: agitation (hypoxia) · projectile vomiting · imminent cardiac arrest

📞 Seek care at a hospital
by calling 911

⚡ If cardiac arrest

Immediately apply C-A-B CPR and use the AED as soon as available