One of the key signs for shock is Altered Mental Status in the absence of head injury. Check casualty every 15 minutes for AVPU.

- A lertness: Knows who, where they are.
- V erbal: Orally responds to verbal commands.
- P ain: Level of pain felt when the sternum is briskly rubbed with the knuckle (if needed)
- U nconscious: Unresponsive
- Decreasing: AVPU could indicate condition worsening

Assess for weak or absent radial pulses and confirm all bleeding con tr ol measures are still effective. It is better to prevent shock with hemorrhage control than to treat it.

DO NOT WAIT for signs and symptoms of shock to occur.