Common classroom challenges in relation to shock

Most challenges you will experience in the classroom are predictable. In this part we cover some of them. While some are generic, they may arise in relation to shock, so are relevant for this course.

Challenge: A learner asks a question you don’t know the answer to

If you are ever unsure about how to answer a learner’s question, don’t make it up on the spot. Instead, manage the situation as follows:

• It is always ok to tell a learner that you are unsure about how to best answer their question and that we are happy to get back to them with a response after their practical session.
• Tell your learner that they can email us their question, and we will respond to them.
• Your learner will feel that you take them seriously and not just brush them off with a standard reply.

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Challenge: You are over-teaching

A common trainer challenge is over-teaching the topic by moving into diagnosis or clinical information that learners do not need to know about in order to provide effective first aid. It may be tempting for you to share knowledge you consider interesting, but your interest does not define the course content.

As extensively covered in this course: when it comes to shock, keep it simple. A useful test is to ask yourself whether a piece of information helps the learner:

• Recognise the familiar problem of shock.
• Apply the familiar solution for shock management.

If it does not support these two tasks, sharing it with your learner will likely do more harm to their effectiveness and confidence in providing first aid than good.

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Challenge: Learners often assume shock only results from severe blood loss

Consider this classroom situation: A learner does not treat for shock during a scenario involving a deteriorating patient because there was no bleeding in the scenario.

The first step for you is to recognise that you may not have explained clearly that shock can be caused by a range of serious illnesses or injuries that include bleeding but also conditions like burns, infection, heart problems and severe allergic reactions.

Step two is to explain this to the learner and make sure they understand.

As a third step, reflect on whether the gap in knowledge only applied to the one learner or whether it may also apply to others. In general:

• It is likely that there are other learners in the same situation, so this is a trigger for you to reinforce this message to the whole group.
• A simple way to achieve this is by including the information in your overall scenario debrief.

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Challenge: A learner says they were told to raise a patient’s legs

Consider this classroom situation: A learner challenges your instruction to not raise the patient’s legs. They say they were taught this in a previous course and challenge your credibility.

In response, acknowledge that it used to be clinical advice to raise legs in first aid and that this was therefore taught in the past. Then explain that:

• Raising the legs in shock is no longer routinely recommended because it only gives a brief, unreliable boost in blood flow and does not improve outcomes.
• It can also make breathing harder and be unsafe or uncomfortable for some injuries and medical conditions.

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Challenge: Learners may under-value reassurance

Consider this classroom situation: During a scenario, a learner turns their back to the patient after having made them comfortable and talks to a bystander while waiting for the ambulance.

In response, remind the learner of the importance of reassurance in the management of shock. Explain to them that:

• Reassurance is not just being kind – it is part of the first aid treatment for shock.
• Keeping someone calm can help stop the body’s fight-or-flight response from making shock worse.
• Reassurance helps the circulation and the brain.
• Talking to and watching the person protects their dignity and helps keep them safer while you wait for more help.

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