It is practically guaranteed that when you become a law enforcement officer, you will undoubtedly witness some shocking events (pun intended) throughout your career. Many of those events will involve some sort of medical element to it. In this week’s Medical Monday, we will be breaking down the different types of shock, and some critically important first aid care that you can provide as an officer.
The simplest definition of shock that I can come up with is that some type of event has happened to the body, and the body’s needs are not being met. Initially in most cases the body will compensate or attempt to compensate. Eventually if shock is not treated, the body will no longer be able to compensate, and the patient will die.
To understand compensation and decompensation when discussing shock, I like to use the example of a city. Imagine a large city such as Los Angeles. The city government provides multiple services such as police, fire, ems. They also provide electrical services, waste services, water services, etc. In order for the city to run efficiently, each service must pull their fair share of the weight and perform their duties well. For our example, imagine that the waste service workers go on strike and refuse to perform trash pick-up. The first couple of weeks may not be too terrible, and the city would be able to compensate. However, if the strike were to go on for months on end imagine the impact on the city that would have. Fire departments would be running more fire calls, police would be running more calls, hospitals would be overcome with sick patients due to disease from the buildup of the trash. The economy of the city would be negatively impacted. If this crisis continued, the city would for all intents and purposes die off if no aid was given.
The human body has a vast array of different systems, organs, and cells that need to work together toward the goal of living and being healthy. If one system is affected significantly, all other systems become affected as well. If not corrected, the body will eventually go into shock.
There are four main categories of shock. Each category breaks down into subcategories. For our purposes today, we will focus on the four main types. They are as follows:
The treatment for this type of emergency is administration of an EpiPen. Most police departments do not have a policy in place nor provide an EpiPen for officers to administer. For this type of shock, it is important to remove the substance causing the reaction. In the case of the patient that has a stinger, it is important to remove the stinger using a scraping motion with a credit card or ID card. Do NOT use tweezers as it could inject more venom into the patient causing a worse reaction. Expedite EMS and allow the patient to position themselves to where it is easiest for them to breathe.
This type of shock is also seen in very sick patients who become septic. Sepsis is a subcategory of this type of shock.
The last subcategory of this type of shock is neurogenic shock. This could be observed in patients with a significant head, neck, or spinal cord injury. The important treatment for a patient experiencing this type of shock is rapid transport to a hospital.
Another medical condition that obstructive shock falls under is pericardial tamponade. The heart sits within a protective sac. When the chest has been struck with a lot of force, that sac can fill with fluid and obstruct the heart from beating efficiently.
With all of that being said, here are the main pearls of wisdom that officers can apply when treating patients prior to EMS arrival.
One last note before we conclude this Medical Monday. It had been taught for many years to elevate the legs of patients in shock. After many medical studies it was found that elevating the legs not only provided no benefit to the patient, in some cases it caused a medical complication called pulmonary edema.
As always, I hope that you enjoyed this installment of Medical Monday. If you have any questions or if you would like to provide further discussion, comment below.