What exactly is the treatment for shock?

Occasionally, I will read or hear in a news story that someone was taken for the hospital and “treated for shock.” For example, if a dragon turned up downtown and bit someone’s head clean off, the newspaper would say: “The victim was dead at the scene and several witnesses were treated for shock.”

What is involved in this treatment typically? For the sake of argument, let’s say I was a witness to the death by dragon. What would they do to me?

Shock is decreased tissue perfusion along with impaired cellular metabolism. It’s generally associated with circulatory collapse, with falling blood pressure, and lack of oxygenation of all tissues. Treatment is directed at restoring blood pressure and tissue perfusion. So the treatment should be aimed at the cause of the shock.

If one is going into shock because of extreme blood loss (hypovolemic shock), replacing blood and fluids is paramount.

If one is shocky due to an overwhelming infection causing the vascular system to dilate and leak vital fluids into the body (septic shock), one must fight the infection and use drugs to constrict the blood vessels, and replace lost fluids that way.

Cardiogenic shock is due to the heart failing to pump blood adequately enough to perfuse the tissue. This may be due to massive heart attack, sudden rupture of heart valves or heart wall, or a buildup of fluid around the heart. Treatment is directed at the underlying cause here too.

A wide variety of other causes of shock exist, with their particular treatments. Neurogenic, anaphylactic, etc.

Best treatment in the field: Stop any obvious bleeding, keep 'em warm, ensure an open airway, elevate their limbs higher than their heart, and get a rescue squad there to give oxygen and fluids as appropriate, and transport them to the nearest ER.

Oh, and take that crayon out of their mouth, too.

Typed “treatment for shock” into Google,

this is the first hit
this is the second hit

And, what Qadgop said.

So, it sounds very much to me, (and this fits with what I already understand,) that the ‘shock’ medical people will treat you for is a complication of serious wounds you get yourself, not being horribly startled at something that you’ve seen happening to somebody else.

In the context of the OP’s newpaper story, then, if the witnesses were treated for shock, then they probably weren’t just witnesses to the entire attack - they might have been witnesses to the head-biting part, who also got mauled a little bit by the dragon as he left?

I suspect the dragon-observers in the OP’s news item were stressed out or hyperventilated or swooned, and were evaluated and told to breath into a paper bag or similar. I’d attribute their being ‘treated for shock’ as 4th estate hyperbole at best.

Hyperventilation and vaso-vagal syncope rarely if ever develop into actual medical shock by themselves.

In the general pathology part of my textbook, heavily borrowed from the human pathology textbook, it mentions underneath neurogenic shock (one of the types of shock) that it can be caused by fear. Now, nowhere does it explain what this “fear” is, and no further explanation is given. I assume it has more importance in the human side than in the animal side.

Qadgop, do you know about this?

Nevermind, I guess you answered…

This is precisely what I was looking for. When people are not directly injured, but are emotionally stressed. I’ve seen it used in the context of witnesses to shootings being carted of by ambulance to be treated for shock. They had not been shot, they had not been injured in any way, they had only seen someone else get injured. Similarly, a pedestrian was hit by a bus near my office, the pedestrian was taken to hospital, but so was a bystander who had only seen the accident and was upset.

That’s why I was wondering exactly what was being treated and why.

I had a close call rescuing a toddler once. About an hour later after the dust had settled and I realized “Wow, I could have died!” I got the shakes and clearly had some kind of delayed stress reaction. A friend said “Oh, you must be in ‘shock’.” But we certainly didn’t rush me to the hospital or anything, he just made me tea.

Is that the kind of “shock” the newspapers are referring to in the case when someone witnesses a violent dragon attack?

Yes, I know how to use Google and even Wikipedia, but found mostly information on shock that had a physical cause. I was interested more in the “shock” as addressed by Qadgop’s second post, which sounds more like “anxiety”.

My understanding is that what you experienced is known as an “acute stress reaction:” Acute stress disorder - Wikipedia.

In Boy Scouts, we learned that you should generally make the victim comfortable, and also “if the face is red, raise the head; if the face is pale, raise the tail [i.e., feet]”.

I am not a MD, But I am an EMT.
In our technician manual neurogenic shock is associated with hypoperfusion due to nerve paralysis such as by a spinal cord injury that results in the inability to control the dilation of blood vessels.
We used to use Psychogenic shock to refer to what today is more commonly called Syncope. It dilates the blood vessels much like neurogenic shock without an injury.
So in the context of what these lay-persons call shock, I say Psychogenic shock.

Treatment is by a good slap to the face. (just kidding)

Totally got it after a couple more posts. This makes me curious when thinking more about it in the context you’re asking, too.

Like, the people who have such an extreme anxiety reaction, are they the ones who would freeze up and not be able to help themselves in a violent situation, or one which would require immediate response, such as a train wreck or explosion?

Not referring to people who have that reaction later, like you describe with your rescue, that seems like a normal response to have after the adrenaline wore off.

I wonder if that’s the kind of thing that separates the “take action” types from the “sit down and cry” types, and what makes them those kind of types? You would think everyone would have a self-preservation “fight” response to extreme situations, but I see many, many, people who are unable to respond appropriately to sudden situations. (to put in more context, I work in an animal ER, and clients are frequently unable to deal with things that happen to their pets, even after some time and TLC from our staff)

Thoughts? Thread hijack?

Interesting. My father told me a story that when he was a Navy Seabee during WWII he had some men digging a deep ditch. There was a cave in and two of the men where completely buried, and died. He told me a third man was only buried to about his knees*, but a few hours later died. My father attributed his death to shock.

*Before any SDMB smart asses show up, yes he was right side up, and standing on his feet at the time.

Here’s my two scents’ worth.

The human endocrine system has two main modes, sympathetic and parasympathetic.

The sympathetic is the one we’re all familiar with, the one that creates that “adrenaline rush” reaction. Bam, and you’re ready for fight or flight.

The parasympathetic is the opposite. Its job is to calm you down. It’s both what brings you back down after an adrenaline rush, and what causes the third stress response, “hide”.

Stress, as we know it, is often caused by a conflict between these two systems. Fear especially can cause a massive biochemical fight between the “flight” and “hide” responses. Do I run from the danger? or hide from it?

Bear with me, I’ll be coming around to “shock” in a paragraph or so. :stuck_out_tongue:

As modern urban people, we’re used to a certain background level of stress. Just walking down the street, we gain stress points from all the strangers we pass, the navigation we’re doing, and so forth. So most of us living in modern society are under a certain amount of biological stress all the time. And different people cope different ways. We are all, to some extent, a house of cards, and the level of stress on the system is the level of weight being supported by those cards.

In regular life, our stress levels do not change so rapidly that we cannot adjust the cards to compensate. But take a major stressor, like seeing someone get et by a dragon, and the whole structure flies apart. Long-suppressed stressors are suddenly unbalanced, and suddenly the endrocrine and nervous systems have way more than they are even meant to handle. Bad mojo, folks.

So “shock”, as you’re describing it **Eats_Crayons, **, is the colloquial term for when this happens. It’s just like someone giving you a massive dose of a cocktail of both stimulants and depressives, and as such, can actually be quite dangerous to your health. The fact that the cause is mental, or “psychogenic”, doesn’t make a difference.

Now, how to treat it : basically, you want to return the patient to baseline as smoothly and quickly as possible. You need to put them in a neutral environment, someplace quiet and dark, very low stimulus. You want to montor their vital signs and carefully counter any extreme reactions. I say carefully, because people in shock often swing wildly from sympathetic to parasymapthetic reactions, and the idea is to remove the energy from the system, slow down the pendulum, not add more energy to the system by trying to counter ione pendulum swing and end up just swining it all the harder in the opposite direction.

So, to sum up (ha), yes, the ‘shock’ they are talking about is real. It’s an extreme stress reaction caused by extremely stressful events, and that includes just seeing something really horrible, like a dragon munching your postman. It’s not just journalistic hyperbole, it’s quite real, and in some cases, could quite literally kill you if untreated.

I hope that clears things up for… somebody. :stuck_out_tongue:

Very interesting. Thanks for the input, everyone.

While waiting for the real medics to show up…

Crush Syndrome

When someones legs get trapped in this way for an extended period of time (depending on the circumstances), circulation can be severely compromised. Two things happen. In the legs, toxic cell breakdown byproducts build up, and the heart stops working so hard (less blood to pump, less body to pump it to).

When the pressure on the legs is relieved and circulation is suddenly restored, all the toxic byproducts start circulating, and blood pressure falls rapidly. Patient goes into shock, and can die. Where possible, inflatable pressure cuffs can be used to stage the process of restoring circulation while the rest of the body is supported with appropriate IV.

Otherwise, the man referenced above could have suffered a thrombosis from a clot that formed in his leg while he was trapped.


Huh. I know you’re a real doctor and I only had a couple of first aid courses, but in those courses the real EMTs who taught them always said that psychological shock can also kill, and that’s why it’s so important to stay with the injured person and talk with them and keep them warm.

That’s my understanding as well. Shock can kill because it’s basically a massive unbalancing of our usual biochemical balances, so you get wild swings between sympathetic and parasympathetic responses.

People who are ‘scared to death’ usually have an underlying health problem which is exacerbated by sudden stress, such as fear. Most such fatalities are due to underlying cardiac disease: Can someone be literally scared to death? - The Straight Dope

In such cases, I’d attribute any resultant cardiogenic (or other shock) to the disease that is causing it, not to the fright which triggered it.

There will always be some folks who die for no discernable reason, while under stress. But to blame it on true medical shock due to fear, with no other complicating illnesses is a bit of a stretch.

And I’d affirm the crush syndrome, too. Massive muscle necrosis will knock off the kidneys, among other organs.

But do you have a cite for sudden fear causing shock? Not sudden fear raising catecholamines and causing a fatal arrhythmia, or massive infarct. Not sudden fear causing a vaso-vagal response. But causing genuine medical shock?