Okay, so you have recognized that there is an emergency, and you have  made a decision to act.  You go
over to the victim and say, “Hi, I’ve had first aid training, can I help?” And they say “No!”   Now what do you do?  Force
the victim to accept your help?  Go about your business?

 No.  If you think that  there is a medical emergency and the victim needs help, just hang around and keep talking.  Sometimes it takes a  little persuading to get a sick or injured person to accept your help.  And remember, it is always your choice  whether to call for help or not, no matter what the victim says. 
 
If you think about it, refusing help when we are sick or hurt isn’t so  unusual.  None of us really wants  five fire/rescue responders, an EMT and a medic, and a couple police officers, plus all the neighbors hanging around, and we’re in our underwear or pajamas!  What we really want to do is to go home and get in bed with the dog or the cat and make it go away.  
 
So be patient.  Keep talking calmly and explain what you would like to do to help.  Tell the victim  what your
training is and try to engage him conversation.  Ask if there is someone he would like you to call.  Eventually he will
accept your help.  

     "Shock" is the failure of the cells of the body to be adequately profused with oxygen.  This can be a result of"

     1.  Substantial loss of blood volume, as in a severe laceration 
     2.  Decreased heart function from Injury or illness, such as a heart attack or trauma to the chest, leaving the heart unable to pump sufficient blood to the tissues
     3.  Dilation of the blood vessels, making the "container" larger than normal, as in anaphylactic shock

    Recognizing the onset of shock isn't always easy, but it doesn't make any difference, because you always treat for shock from the very beginning of your rescue!  If you wait until you think the victim is going into shock, it is probably too late.   

    So how do you treat for shock? 

    1.  First, treat the underlying pathology.  For example, stop the bleeding
    2.  Second, place the person in a "position of comfort."  Lying down is often best, but not always.  Heart attack        victims often can't breath when they are lying down, and some people will feel claustrophobic or panicky in a prone position.  Ask them how they feel most comfortable.  
    3.  Maintain body temperature.  We used to say, keep the patient warm, but this is clearly inappropriate on a high humidity, 100 degree day.
    4.  Reassure the person.  This is extremely important.  As discussed in a previous post, your voice and calmness can go a long way toward keeping a person from panicking.  Talk to the individual, but slowly and calmly and with good eye contact.  Don't be afraid to interject a little humor if it seems appropriate.  Surprisingly, sick or hurt people often joke about their condition.  Play along with them.  

    As always, be careful not to discuss the patient's condition within his or her hearing.  

    Shock can be deadly, so remember:  Always treat for shock from the very beginning!