with the signs and symptoms of shock so that the condition may be anticipated, recognized, and dealt with effectively. The best approach to shock treatment is to treat all survivors suffering from moderate and severe injuries for shock. Act! Don’t wait! Anticipate shock and take care of it along with treatment of the specific injury. . Giving a survivor fluids by mouth in the treatment of shock is normally not recommended. However, in survival situations, recovery may often depend on adequate hydration. In an early shock incident, giving the survivor small amounts of fluid by mouth maybe beneficial, provided he is conscious, can swallow, and has no internal injuries. Burn victims particularly need large amounts of water to replace their loss of fluids. . Emotional shock frequently follows an emergency. This type of shock originates in the m i n d  a n d  m a y  o c c u r  e v e n  w i t h o u t  i n j u r y. Resistance to and the impact of this type of shock varies widely. It depends on your physical makeup and is related to the amount of training you have previously received. Comfort and reassurance coupled with rest and relaxation after you are clear of immediate dangers is very effective in manage- ment of the survivor suffering from emotional shock. Symptoms of Shock A person suffering from shock shows symp- toms that are directly or indirectly related to the poor circulation of the blood. The pulse is weak and rapid. Breathing is likely to be shallow, rapid, and irregular, because the poor circulation of the blood affects the breathing center in the brain. The temperature near the surface of the body is l o w e r e d  b e c a u s e  o f  t h e  p o o r  b l o o d  f l o w ; therefore, the face, arms, and legs feel cold to the touch. Sweating is likely to be very noticeable. A person in shock is usually very pale, but in some cases there may be a bluish or reddish color to the skin. The pupils of the eyes are usually dilated (enlarged). If the victim is conscious, he may complain of thirst. He may have a feeling of weakness, faintness, or dizziness. He may feel nauseous. Also, the person may be very restless and feel frightened and anxious. As shock deepens, these signs gradually disappear and the victim becomes less and less responsive to what is going on around him. Even pain may not arouse him. Finally, the victim may become unconscious. It is unlikely that you will see all these symptoms of shock in any one case. Some of them appear only in the late stages of shock when the disturbance of the blood flow has become so great that the victim’s life is in serious danger. Sometimes the signs of shock maybe disguised by other signs of injury. It is important to know what symptoms indicate the presence of shock, but do not ever wait for symptoms to develop b e f o r e  b e g i n n i n g  t h e  t r e a t m e n t  f o r  s h o c k. Remember, EVERY SERIOUSLY INJURED PERSON IS LIKELY TO DEVELOP SERIOUS S H O C K . Treatment of Shock In many emergency situations, the most helpful thing you can do for an injured person is to begin treatment for shock. If shock has not yet developed, the treatment may actually prevent its occurrence; if it has developed, you may be able to keep it from reaching a critical point. As we have seen, shock creates a vicious cycle—that is, the worse it is, the worse it becomes. It is extremely important that you begin treatment at the earliest opportunity. It is important to keep the victim as calm as possible because excitement and fright will affect his condition and may even bring on shock. Try to prevent the victim from seeing his injuries, and reassure him that he will be properly cared for. Keep all unnecessary persons away, as their conversation regarding the victim’s injuries may increase his agitation. A  p e r s o n  i n  s h o c k  i s  o f t e n  t h i r s t y .  No particular harm will be done if you allow the victim to moisten his mouth and lips with cool water, if it will make him more comfortable. But in general, there is no need to give him anything to drink unless you are in a position where medical assistance will not be available for an excessively long period of time. If medical care will not be available, you should give the victim SMALL AMOUNTS of warm water, preferably mixed with 1 teaspoon of salt and 1/2 teaspoon of baking soda per quart or liter. This should be done if he is conscious, able to swallow, and has not suffered internal injuries. In the case of burns, an exception must be m a d e  t o  t h e  r u l e  o f  n o t  g i v i n g  l i q u i d s .  A seriously burned person has an overwhelming need for fluids. It is, therefore, a permissible and even desirable part of first-aid treatment for burns to give water or other liquids. Sweet tea, fruit 5-39