From ‘shock’ to ‘seriously ill’. How the language of first aid is changing.

Until now, one of the most common words used to describe someone who was in a very bad way after an accident, severe illness or major injury was ‘shock’.

It was understood to mean that the person have suffered some sort of very severe trauma and was in urgent need of serious medical care.

First responders and first aiders would describe someone as being ‘in shock’.

Operators on the Triple Zero line would ask bystanders attending the person for any signs they had gone ‘into shock’ as a way to prioritise their case.

But under new guidelines issued by ILCOR (the International Liasion Committee on Resuscitation) the term ‘shock’ is gradually being phased out in favour of a new term ‘Seriously Ill’

There are multiple reasons for this change. And it’s particularly important for anyone in the First Aid training industry and anyone being trained in CPR & First Aid to know the reasons why. And to start using this term themselves.

Why is the word ‘shock’ being replaced by ‘seriously ill’?

It’s not just that the word for a set of signs and symptoms that is changing. Along with the new terminology comes an expanded range of signs and symptoms being covered as well.

But let’s start with the reason why the word ‘shock’ has lost its true meaning in a clinical sense.

The simple truth is this.

Describing someone as being “in shock” used to have real medical validity.

But now the term has been so ruined, mostly by the media, that it has no real value any more.

We’ve all seen headlines like:

“Coach in shock after team’s big loss”

“Woman shocked at the size of her electricity bill”

“Man in shock at first date’s behaviour”

Of course none of these headlines describe an actual condition of shock. And none of them are comparable to someone who’s been seriously injured in a car accident, almost drowned, had a heart attack or cardiac arrest, experienced severe blood loss, etc

The problem is not that people don’t experience shock anymore. They do.

But the word being used to describe it is no longer adequate because it has been misused and therefore devalued!

Real shock, as first aiders and first responders know it, is actually a life-threatening medical emergency. It happens when your body does not get enough blood flow, meaning oxygen cannot reach your organs and tissues.

Common signs & symptoms of shock

As shock develops, a person may show several physical and mental signs including:

• Skin changes: The person’s skin becomes cold, clammy or sweaty. They look pale. There is a blue or gray tinge to their lips, fingernails or face.

• Breathing & pulse: Their breathing becomes rapid and shallow. They develop a fast but weak pulse.

• Mind & mood: They exhibit anxiety and restlessness, accompanied by confusion, dizziness or extreme weakness. Unable to stand or walk.

• Other signs: They may have nausea or vomiting or an excessive thirst. And they may faint and lose consciousness. All of these are very serious symptoms. But clearly none of them apply to a coach whose footy team just lost, a woman with a large power bill or a man who had a bad first date.

  
  

And this is why ONLY the terminology is changing. Because people no longer understand what ‘being in shock’ means.

Why we need to make the change from ‘shock’ to seriously ill

To a bystander, the word shock can mean anything from psychological distress to emotional surprise or minor injuries. This can make it hard for them to recognise just how seriously ill a person they are trying to help may be.

Shifting the language from ‘shock’ to ‘seriously ill’ makes it easier for a bystander to recognise the gravity of the emergency and so act accordingly.

Medically speaking, clinical ‘shock’ is frequently a later-stage manifestation of severe systemic issues. By training first responders to recognise a broader presentation of serious illness symptoms, which include such things as anaphylactic & septic shock and severe blood or fluid loss, then they are more likely to call for an ambulance and administer first aid.

The earlier this recognition of someone as being ‘seriously ill’ can occur, the better outcome they are more likely to achieve when they are admitted to hospital and the more likely they will receive the right, targeted interventions.

But another reason the language is changing is to ensure that first aiders and first responders capture additional serious conditions likes SEPSIS, as well as shock.

Sepsis is a life-threatening medical emergency usually caused by an extreme and harmful immune response to an infection. It can kill someone in as little as 12 hours if it is undiagnosed and leads to septic shock.

The risk of death from sepsis can increase by 4% - 9% for every single hour that medical treatment is delayed.

New Indicators of a "Seriously Ill" Person

First aiders will soon be being taught to look for combinations of the following signs to trigger immediate emergency medical activation:

• Breathing changes: Rapid breathing (≥22 breaths per minute in adults) or severe breathlessness.

• Skin presentation: Pale, blotchy, bluish, or mottled skin, or a non-blanching rash.

• Mental state: Restlessness, agitation, confusion, slurred speech, or a decreased level of consciousness.

• Physical distress: Shivering, rigors, severe muscle pain, or passing little to no urine.

How the changes will roll out

The change from saying someone is SERIOUSLY ILL as opposed to being in shock, will occur gradually.

Soon you will hear this term being rolled out across first aid training materials and being used in the medical field among first responders and hospital staff.

This whole exercise is more than just changing a label or name of the same thing.

It is a genuine attempt to broaden the scope of the original review of the person to ensure that they are properly assessed for how seriously ill they actually are. This will ensure that they are given the right first aid treatment, quickly and effectively.

And that ambulance or other medical personnel are informed correctly, as early as possible just how severely unwell this person is.

If you are someone who regularly trains in First Aid or even does a 12 monthly refresher course

on CPR you will notice the use of the term ‘shock’ disappearing from training sessions and being replaced by ‘seriously ill’.