What are common signs of shock in an injured athlete and the appropriate on-site management?

• A. Cold, clammy skin; rapid pulse; confusion; call EMS, lay down if not spine-injured, elevate legs, keep warm
• B. Bright flushed skin; slow pulse; rest quietly
• C. Pale but dry skin; slow breathing; move the athlete
• D. Nausea and vomiting only; no EMS

Answer: (A)

When shock is present, the body shows signs of reduced perfusion: the skin becomes cold and clammy, the pulse is rapid and weak, and the person may be confused or anxious. These symptoms reflect the body's attempt to shunt blood to vital organs, which can rapidly deteriorate if not treated.

The best on-site management starts with calling EMS immediately. If there’s no suspicion of a spinal injury, help the athlete lie on their back and elevate the legs to improve blood return to the heart, then cover them to keep warm. Throughout, monitor breathing and pulse and be ready to perform CPR if breathing stops. If a spinal injury is suspected, do not move the athlete; keep them still, support the head and neck, and await EMS. Control any visible bleeding with direct pressure and avoid giving the athlete food or drink.

Other descriptions of signs or actions don’t fit shock or don’t address the appropriate immediate steps, so recognizing the cold, clammy skin, rapid pulse, and confusion—and responding with prompt EMS, positioning, and warmth—best match the correct approach.