The  pupils  of  the  eyes  are  usually  dilated (enlarged). A conscious person in shock may complain of thirst and have a feeling of weakness, faintness, or dizziness.  The  victim  may  feel  nauseous,  restless, frightened, and/or anxious. As shock deepens, these signs gradually disappear and the victim becomes less and less responsive to what is going on. Even pain may not arouse the shock victim. Finally, the victim may become unconscious. You will not likely see all the symptoms of shock in any one case. Some of them may appear only in late stages of shock when the disturbance of the blood flow has become so great that the person’s life is in serious danger. Sometimes the signs of shock may be disguised by  other  signs  of  the  injury.  You  must  know  what symptoms indicate the presence of shock, but don’t ever wait for symptoms to develop before beginning the treatment  for  shock.    Remember,  every  seriously injured person is likely to develop serious shock! PREVENTION AND TREATMENT OF SHOCK You should begin treatment for shock as soon as possible. Prompt treatment may prevent shock or, if it has already developed, prevent its reaching a critical point.  Keep  the  victim  lying  down  and  warm.  If conscious, the victim should be encouraged and assured that expert medical help will arrive soon. Keep  an  injured  person  warm  enough  for comfort,  but  do  not  let  the  victim  become overheated. The best position to use to prevent or to treat shock is one that encourages the flow of blood to the brain. If possible, place the injured person on his or her back on a bed, a cot, or a stretcher. Raise the lower end of the support about 12 inches so that the feet are higher than the  head  (fig.  14-15).  If  you  can’t  do  that  and  it’s possible, raise the feet and legs enough to help the blood flow  to  the  brain.  Sometimes  it’s  possible  to  take advantage of a natural slope of ground and place the victim so that the head is lower than the feet. Of course in every case, you’ll have to consider what type of injury is present before you can decide on the best position. Here are some examples: If a person has a chest wound, he/she may have so much trouble breathing that you will have to raise the head slightly. If the face is flushed, rather than pale, or if you have any reason to suspect a head injury, don’t raise the feet. Instead, you should keep the head level with or slightly higher than the feet. If the person has broken bones, you will have to judge what position would be best both for the fractures and for shock. A fractured spine must be immobilized before the victim is moved at all, if further injuries are to be avoided. If you have any doubts about the correct position to use, have the victim lie flat on his/her back.  The basic position for treating shock is one in which the head is lower than the feet. Do the best you can under the particular circumstances to get the injured person into this position. In any case, never let a seriously injured person sit, stand, or walk around. Administer  liquids  sparingly,  and  not  at  all  if medical attention will be available within a short time. If necessary, small amounts of warm water, tea, or coffee may be given to a victim who is conscious. Persons having serious burns are an exception. Burn victims require large amounts of fluids. Water, tea, fruit juices, and sugar water may be given freely to a victim who is conscious, able to swallow, and has no internal injuries. Slightly  salted  water  is  also  beneficial.   Never  give alcohol to a person in shock. An injured person may or may not be in pain. The amount   of pain felt depends in part on the person’s physical condition and the type of injury. Extreme pain, if not relieved, can increase the degree of shock. Make 14-15 Student Notes: Figure 14-15.—Position for the treatment of shock.