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                            CIRCULATION - SHOCK
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   This is a condition of general bodily weakness resulting from some
   form of injury or illness which has reduced the volume of blood or
   fluid in the body. It can vary from faintness to complete collapse.
   Commonly referred to as Traumatic (injury) shock, this is a serious
   condition which may prove fatal even when the casualty's injuries
   have been adequately treated.

   Shock can be caused by the following examples of blood/fluid loss:
   loss of blood by internal or external bleeding; loss of plasma from
   major burns; loss of water due to intestinal obstruction; recurrent
   vomiting or severe diarrhoea; accute abdominal emergencies; or a 
   heart attack. Extreme pain or Fear can produce a similar state.


   Symptoms & Signs
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   The body reacts to shock by directing more blood to the arteries 
   supplying the vital organs ( eg brain, heart and kidneys ) at the
   expense of those supplying the less important tissues ( eg muscle
   and skin ). As the casualty's condition deteriorates the symptoms
   and signs will become more pronounced:

   Casualty will feel weak, faint and giddy and be anxious and restless.
   
   Casualty may feel sick and may vomit.

   Casualty could feel very thirsty.

   Skin becomes very pale, cold and clammy sweating might develop.

   Breathing may become shallow and rapid; casualty may be yawning or
   sighing.

   Pulse rate increases but becomes weaker and sometimes irregular as
   blood/fluid volume drops.

   Unconsciousness may develop.

   There may be evidence of associated external or internal injury.


   The Aim
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   Ensure an adequate blood supply to the heart, lungs or brain. 
   Determine the cause of shock, treat it an arrange removal to 
   Hospital.


   Treatment
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   1:   Immediately reassure and comfort the casualty. In some cases
        the casualty is not fully aware what is happening to them. They
        become frightened and this can enhance the effects of shock.

   2:   If the casualty's condition allows, lay the casualty down on the
        back on a blanket. Keep the head low and turned on one side 
        ( to maintain blood supply to the brain and to lessen the dangers
        of vommiting ). Raise the leg unless you suspect fractures.

   3:   Keep the casualty warm. Cover the casualty with a blanket.

   4:   Loosen any tight clothing to help the circulation and help 
        breathing.

   5:   Search for and, if possible treat the cause of the shock.

   6:   If the casualty complains of thirst, moisten the lips with
        water but DO NOT give anything to drink.

   7:   Check breathing rate, pulse and levels of responsivness at
        10-minute intervals.

   8:   If the casualty's breathing becomes difficult, if vommiting
        is likely or if the casualty become unconscious, place in the
        Recovery Position. ( See Resusitation )

   9:   If breathing and heartbeat stop, begin Resusitation immediately.
        

   10:  Remove to Hospital immediately. Transport as a stretcher case
        maintaining the treatment position.

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