most relevant issues to bdsm, S/m and rope/rigging are low blood pressure, dehydration and if they fell, a spinal injury
This is a serious medical condition and requires emergency medical attention as it could be life threatening. Call 911.

## Signs and symptoms of shock

vary depending on circumstances and may include:

* Cool, clammy skin
* Pale or ashen skin
* Rapid pulse
* Rapid breathing
* Nausea or vomiting
* Enlarged pupils
* Weakness or fatigue
* Dizziness or fainting
* Changes in mental status or behavior, such as anxiousness or agitation
## Seek emergency medical care

If you suspect a person is in shock, call 911 or your local emergency number. Then immediately take the following steps:

* Lay the person down and elevate the legs and feet slightly, unless you think this may cause pain or further injury.
* Keep the person still and don’t move him or her unless necessary.
* Begin CPR if the person shows no signs of life, such as breathing, coughing or movement.
* Loosen tight clothing and, if needed, cover the person with a blanket to prevent chilling.
* Don’t let the person eat or drink anything.
* If you suspect that the person is having an allergic reaction, and you have access to an epinephrine autoinjector, use it according to its instructions.
* If the person is bleeding, hold pressure over the bleeding area, using a towel or sheet.
* If the person vomits or begins bleeding from the mouth, turn him or her onto a side to prevent choking, unless you suspect a spinal injury.


## and emotional distress:
It’s a subjective experience for the bottom/submissive, usually from feeling; isolated, alone, humiliated, unsupported, confused, threatened, ashamed/guilty
Recommended – to allow 24 hrs minimum for them to process and recover, then have a debriefing session of more than 2 hrs plus follow up. It’s important not to overpower them or deny their feelings.

## Cognitive:

* Intrusive thoughts of the event that may occur out of the blue
* Nightmares
* Visual images of the event
* Loss of memory and concentration abilities
* Disorientation
* Confusion
* Mood swings

## Behavioral:

* Avoidance of activities or places that trigger memories of the event
* Social isolation and withdrawal
* Lack of interest in previously-enjoyable activities

## Physical:

* Easily startled
* Tremendous fatigue and exhaustion
* Tachycardia
* Edginess
* Insomnia
* Chronic muscle patterns
* Sexual dysfunction
* Changes in sleeping and eating patterns
* Vague complaints of aches and pains throughout the body
* Extreme alertness; always on the lookout for warnings of potential danger

## Psychological:

* Overwhelming fear
* Obsessive and compulsive behaviors
* Detachment from other people and emotions
* Emotional numbing
* Depression
* Guilt – especially if one lived while others perished
* Shame
* Emotional shock
* Disbelief
* Irritability
* Anger
* Anxiety
* Panic attacks

## . . . . sources
**medical shock**
[medical shock][]
[first aid][]
[Mayo Clinic – shock][]
[NIH – cardiogenic shock][]
[what causes shock?][]
[what is shock?][]
## . . . .
**emotional shock**
[signs & symptoms of emotional trauma][]
[cause and effect][]
[first aid for emotional shock][]
[recovery from trauma][]
[web MD – 10 signs of an ailing mind][]

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