How should a casualty in shock be positioned if there is no suspected spinal injury?

• A. Lie flat, raise the legs about 12 inches, and keep warm.
• B. Sitting upright with legs dangling.
• C. On the side with knees bent.
• D. Stand up to improve circulation.

Answer: (A)

When someone is in shock, the priority is to maximize blood flow to the heart and brain while keeping them warm. The best position when there’s no suspected spinal injury is to lie them flat on their back and raise the legs about 12 inches. This helps push blood back toward the central circulation (increasing venous return and improving perfusion to vital organs) without compromising the airway. Keeping them warm reduces heat loss, which can worsen shock.

Sitting upright reduces the return of blood to the heart, which can lower blood pressure and worsen circulation. Lying on the side with knees bent isn’t optimal for shock because it doesn’t optimize venous return or airway protection, and standing up would cause blood to pool in the legs, further decreasing blood flow to essential organs.