Some indications for use of the pneumatic
counter-pressure devices are as follows:
1. Systolic blood pressure less than 80 mm Hg
2. Systolic blood pressure less than 100 mm
Hg and the patient exhibits the classic signs
3. Fracture of the pelvis or lower extremities.
The only absolute contraindication in their
use is pulmonary edema, although condi-
tional contraindications include congestive
heart failure, heart attack, stroke, preg-
nancy, abdominal evisceration, massive
bleeding into the thoracic cavity, and
penetrating wounds where the object is still
impaled in the victim.
Application of the anti-shock garment is a
relatively simple procedure but requires some im-
portant preliminary steps. When the garment is
laid out flat, ensure that there are no wrinkles.
If clothing is to remain on the patient, remove
all sharp and bulky objects from the patients
pockets. Take vital signs before applying the gar-
ment. The garments are inflated only sufficiently
to bring the patients systolic blood pressure to
100 mm Hg and maintain it there. Once the gar-
ment is inflated, take vital signs every 5 minutes.
The garment is removed only under the direct
supervision of a physician, There is no indication
for the pre-hospital removal of anti-shock
Other shock treatment procedures to use are
1. Maintain an open airway. Oxygen may also
be administered if proper equipment is
2. Control hemorrhage.
3. Check for other injuries that may have
been sustained. Remove the victim from
the presence of identifiable causative
4. Place the victim in a supine position, with
the feet slightly higher than the head (shock
position). Certain problems, such as
breathing difficulties or head injuries, may
require other positioning.
5. Reduce pain by splinting fractures, pro-
viding emotional support, and attending to
the victims comfort. Unless contrain-
dicated, aspirin may be dispensed.
6. Conserve body heat.
7. Avoid rough handling and transport the
victim to a medical treatment facility.
8. If transportation to a definitive care facility
will be lengthy or delayed, seek the radio
or phone advice of a medical officer on
whether or not to give fluids by mouth or
to start an intravenous line. If this is im-
possible, use your own judgment. Car-
diogenic shock is the only exception to this
rule. DO NOT start intravenous fluids
since volume is sufficient and only func-
tion is impaired.
9. Constantly monitor and record vital signs
every 15 minutes so that you are able to
keep track of the victims progress.
As a corpsman in the field or on board ship
in wartime, you may be issued morphine for the
control of shock through relief of severe pain.
You will be issued this controlled drug under very
strict accountability procedures. Possession of this
drug is a medical responsibility that must not be
Morphine is the most effective of all pain-
relieving drugs. It is most commonly available in
syrettes or tubex in premeasured doses. Properly
administered in selected patients, it will relieve
distressing pain and assist in the prevention of
shock. The adult dose of morphine is 8 to 16 mg
repeated, if necessary, in not less than 4 hours.
Morphine has several undesirable effects,
and these must be thoroughly
understood by the corpsman.
1. Morphine is a severe respiratory depressant
and therefore must not be given to patients
in moderate or severe shock or to patients
in respiratory distress.
2. Morphine increases intracranial pressure
and may induce vomiting; these effects may
be disastrous in head injury cases.
3. Morphine causes constriction of the pupils
(pinpoint pupils); this effect prevents the
use of the pupillary reactions for diagnosis
in head injuries.
4. Morphine is cardiotoxic and a peripheral
It may cause profound
hypotension in small doses in the patient
5. Morphine poisoning is an ever-present
danger. There is a narrow safety margin
between the amounts of morphine that may