Which of the following are common signs of shock?

• A. Restlessness, irritability, altered level of consciousness, pale/ashen/cool/moist skin, rapid breathing, rapid/weak heartbeat, and excessive thirst.
• B. Severe localized pain at the injury site only.
• C. Skin is hot and red with no other symptoms.
• D. Sudden fainting with no other symptoms.

Answer: (A)

Shock is a life-threatening situation in which the body's tissues aren’t getting enough blood flow. The signs described here reflect the body's attempt to preserve blood flow to vital organs and to show that perfusion is dropping. Restlessness or irritability happens because the brain isn’t receiving enough oxygen. An altered level of consciousness signals that mental status is affected by reduced perfusion. Skin that is pale, ash-colored, cool, and moist shows vasoconstriction and poor overall perfusion. Breathing tends to become rapid as the body tries to bring in more oxygen, and the heartbeat becomes rapid and weak as blood pressure falls. Excessive thirst is a sign of dehydration and fluid loss, which can accompany shock.

The other options don’t fit the typical pattern of shock. Severe localized pain stays at a single injury site and doesn’t indicate a whole-body response. Skin that is hot and red with no other symptoms isn’t consistent with the cool, pale skin often seen in shock. Sudden fainting can occur, but it isn’t by itself the signature cluster of signs that points to shock.

If you suspect shock, call emergency services and try to keep the person lying flat, warming them if needed, and monitor their breathing and consciousness until help arrives.