Blotchy bluish skin, especially around the mouth.
5-14. PREVENTING/TREATING SHOCK
Initiate procedures to control shock even if signs and symptoms are not yet
a. Position the Casualty. 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. Elevate the casualty's legs so that his feet are slightly higher
than the level of his heart. (This helps the blood in the veins of his legs to return to his
heart.) Place a small log, field pack, box, rolled field jacket, or other stable object under
the casualty's feet or ankles in order to maintain the elevation. Exceptions to the normal
shock position are described below.
Do not elevate the legs until all lower limb fractures have been splinted.
(1) Spinal injuries. Keep a casualty with a suspected spinal fracture or a
severe head injury as immobile as possible. Do not elevate the casualty's legs.
Immobilize his head, neck, and back, if possible.
(2) Open chest wounds. If the casualty wants to sit up, help him to sit with
his back to a wall, tree, or other support. Setting up may help him to breathe easier. If
the casualty wants to lie down, position him so that he is lying on his injured side.
(Lying on his injured side may help to control pain. Also, this permits the uninjured side
to breathe easier.)
(3) Open abdominal wounds. Keep the casualty on his back with his knees
flexed (raised) with his feet on the ground. Keeping the knees flexed reduces stress to
(4) Minor head wound. A casualty with a minor head wound should be
allowed to sit up. If the casualty has bleeding into the mouth or if he does not want to sit
up, position him on his side with his wound up and his head turned so that fluid can
drain from his mouth.
(5) Unconsciousness. Position an unconscious casualty on his side with his
head turned so fluids can drain from his mouth. If the casualty vomits, quickly perform a
finger sweep to clear his airway.