Combat Life Saver
Lesson 8
PREVENT SHOCK
Compiled and edited by,
2LT John C. Miller, PA-C
Lesson 8
PREVENT SHOCK
INTRODUCTION
There are several causes of shock. On the battlefield,
hypovolemic shock due to loss of blood from wounds
or burns will be the primary type of shock present. If
not properly treated, shock can be fatal. The
procedures used to treat shock are also used to help
prevent shock from occurring.
PREVENT SHOCK
TASK
Identify the procedures for preventing/controlling
shock.
CONDITIONS
Given multiple-choice examination items pertaining to
shock.
STANDARD
Score 70 or more points on the 100-point written
examination.
IDENTIFY THE SIGNS AND SYMPTOMS OF
SHOCK
Loss of body fluids from severe bleeding, burns,
vomiting, diarrhea, and severe heat illness.
Sweaty but cool (clammy) skin, pale skin color,
and/or blotchy or bluish skin around the mouth.
Nausea.
Anxiety (casualty restless or agitated).
Mental confusion.
Increased breathing rate.
Unusual thirst.
POSITION THE CASUALTY TO
PREVENT/CONTROL SHOCK
Move the casualty to cover if possible.
Stop heavy bleeding and treat major wounds.
Normal Shock Position
Position the casualty on his back.

If possible, place a poncho or blanket under the casualty to
protect him from the temperature or dampness of the
ground.
POSITION THE CASUALTY TO
PREVENT/CONTROL SHOCK
Elevate the casualty's legs so his feet are slightly
higher than the level of his heart. Place a small log,
field pack, box, rolled field jacket, or other stable
object under the casualty's feet or ankles to maintain
the elevation.

If the casualty has a fractured leg, do not elevate the legs
until the fracture has been splinted.
POSITION THE CASUALTY TO
PREVENT/CONTROL SHOCK
Shock Positions for Special Injuries
Certain casualties are not placed in the normal
position for shock. Check for and splint fractured
limbs before moving the casualty.
Suspected fracture of the spine. Do not move a
casualty with a suspected spinal fracture or severe
head wound. Do not elevate his legs.
Open chest wound. Place the casualty in a sitting
position with his back to a wall, tree, or other support
or lying on his injured side.
POSITION THE CASUALTY TO
PREVENT/CONTROL SHOCK
Open abdominal wound. Place the casualty on his
back with his knees flexed.
Minor head wound. Place the casualty in a sitting
position with his back to a wall, tree, or other support
or lying on his side with the wound away from the
ground.
Unconsciousness. Position an unconscious casualty
on his side with his head turned so fluids can drain
from his mouth.
TAKE ADDITIONAL MEASURES TO
PREVENT/CONTROL SHOCK
Reassure the Casualty
Keep the casualty calm.
Tell the casualty that you are helping him. Be
confident and have a "take charge" attitude.
Do not make comments regarding the casualty's
condition.
Loosen the Casualty's Clothing
Loosen any binding clothing, including boots, if you
are not in a chemical environment.

Do not loosen or remove clothing in a chemical environment.
TAKE ADDITIONAL MEASURES TO
PREVENT/CONTROL SHOCK
Keep the Casualty From Being Too Warm or Too
Cool
In warm weather, move the casualty to a shade or
erect an improvised shade using a poncho and sticks
or other available materials. Do not cut off air flow.
Fan the casualty with a shirt or other material.
In cool weather, cover the casualty with a blanket,
poncho, or other materials to keep him warm and dry.
Place a poncho under the casualty to prevent chilling
due to contact with cold or wet ground.
TAKE ADDITIONAL MEASURES TO
PREVENT/CONTROL SHOCK
Seek Help or Evacuate Casualty

A combat lifesaver should administer intravenous fluids to
help control shock if hypovolemic shock is present. An
intravenous infusion can be started before a fracture is
splinted.
Evacuate the casualty if practical.
If you leave the casualty to seek help, tell him you are
going to get help and will return. Turn the casualty's
head so fluids can drain from his mouth.
PREVENT SHOCK
CLOSING
Hypovolemic shock can be fatal if fluid loss is not
controlled and fluids are not replaced. Administering
fluids by intravenous infusion is one of the primary
combat lifesaver skills and will be covered in the
medical phase of the course. This lesson is tested
on the written examination.
Questions