LIFE-THREATENING PROBLEMS - Medicine for Mountaineering and Other Wilderness Activities - page 31

which occurs because the nerves that normally constrict the blood vessels are interrupted
and the vessels dilate.
The initial care for such an individual parallels that for hemorrhagic shock, but it is par-
ticularly critical to minimize motion of the spine because occasionally paralysis is revers-
ible ( Chapter 8: Head and Neck Injuries ) . Elevation of the legs should be done carefully
to avoid further injury to the spinal cord, but this maneuver to enhance blood return to the
heart may be particularly effective for individuals with neurogenic shock. If the signs of
progressive shock develop, associated acute blood loss may be present, which is critical in
considering the timing of evacuation.
Septic Shock/Infection
Septic shock occurs with overwhelming infection. The signs of shock are similar to
hemorrhagic shock, with the notable exception that the individual invariably has a high
fever and warm extremities. Septic shock requires considerable time to develop, but its oc-
currence is an ominous sign mandating immediate evacuation. Antibiotics should be given
according to the likely site of infection.
Anaphylactic Shock
Anaphylactic shockiscausedbyexposuretoasubstancetowhichanindividualisaller-
gic, and typically the offending allergen is contained in food ( Chapter 23: Allergies ) . Vir-
tually always, the affected individual is aware of significant allergies and has had similar
previous symptoms.