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First aid: Treating shock

Anyone who has fallen from a horse is usually a little shaken, but a frighteningfall and injury can make shock much worse.

When someone goes into shock, the circulatory system fails, depriving the body of oxygen. Permanent organ damage and death can occur if immediate action is not taken.

The most common cause of shock is severe blood loss: anything more than one litre will trigger the condition, as will other injuries that cause excessive loss of fluids, such as vomiting, or severe burns.

Recognising shock

The early signs of shock include a rapid pulse, pale, cold and clammy skin and sweating.

As shock develops, the skin becomes grey/blue. This is most recognisable inside the lips. Also, if fingernails or earlobes are pressed, they do not instantly regain their colour.

The person may experience weakness or dizziness, nausea or vomiting, thirst, rapid shallow breathing and a weak pulse, often called thready (when the pulse at the wrist disappears, half the body’s blood has been lost).

As the oxygen supply to the brainweakens, the person may become restless or aggressive and yawn or gasp for air. Loss of consciousness may occur and the heart can stop.

What to do

  • Lay the casualty down, insulating them from the ground (use a blanket if available)
  • Treat possibly causes of shock such as severe bleeding or burns, and try to be reassuring
  • Raise and support the legs as high as possible to improve blood supply to vital organs
  • Loosen tight clothing, particularly around the neck, chest and waist
  • Keep the casualty as warm as possible using blankets and clothing, but not direct sources of heat
  • Dial 999. Do not allow the stricken rider to eat, drink or smoke
  • Moisten lips, if thirsty, and do not leave the casualty unattended (except to fetch help)
  • Encourage the casualty to be still
  • Monitor and record vital signs, breathing, pulse and response
  • If the rider loses consciousness, open the airway, check breathing and be ready to give rescue breaths or start CPR

Some people may experience some of the same effects after a frightening experience. This is quite natural. If there is no injury or illness associated with the condition, the person will quickly return to normal, but they may need plenty of reassurance, and should not be left along until they have recovered.

  • For more information on learning first aid skills contact the St John Ambulanceor visit: www.sja.org.uk
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