# What exactly is the treatment for shock? **URL:** \ **Category:** Factual Questions\ **Created:** [January 29, 2009, 1:30am UTC](https://boards.straightdope.com/t/what-exactly-is-the-treatment-for-shock/483478 "2009-01-29T01:30:57Z")\ **Posts on this page:** 6\ **Page:** 2
**Author:** ![MichaelJohnBertrand](https://avatars.discourse-cdn.com/v4/letter/m/dfb087/32.png) [@MichaelJohnBertrand](https://boards.straightdope.com/u/MichaelJohnBertrand)\ **Post date:** [January 29, 2009, 7:49pm UTC](https://boards.straightdope.com/t/what-exactly-is-the-treatment-for-shock/483478/21 "2009-01-29T19:49:27Z")
> [@Qadgop\_the\_Mercotan](#): > > 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? Ah, I think we’re in the tricky landscape of proper versus colloquial usage. I do not know what you mean by “medical shock”. As I said, oh, way the heck back, I’m talking about the word “shock” that a journalist might use when they say “And several witnesses were treated for shock”. I’ve always assumed that this meant, roughly, “they were treated for the potentially dangerous effects of extreme emotional upset and/or trauma”. I don’t know if that is what “medical shock” is… I suspect it is not. So when, for instance, a doctor on a medical show says “They’re going into shock!”, they probably mean what you refer to as “medical shock” from extreme **physical** trauma. But the sort of shock one might get from witnesses a dragon chewing thoughtfully on a traffic cop is likely different. Someone mentioned “psychogenic shock” (I think they played here in the 60’s) and that might be the ticket. Are we agreed that sudden, extreme emotional stress can damage one’s health? ---
**Author:** ![Telemark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/telemark/32/372_2.png) [@Telemark](https://boards.straightdope.com/u/Telemark)\ **Post date:** [January 29, 2009, 10:05pm UTC](https://boards.straightdope.com/t/what-exactly-is-the-treatment-for-shock/483478/22 "2009-01-29T22:05:42Z")
> [@MichaelJohnBertrand](#): > > I do not know what you mean by “medical shock”. From earlier in the thread: > [@](#): > > 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. So, for a variety of possible reasons, oxygenated blood isn’t making it to the cells. Fear, by itself, usually can’t do that. Loss of blood, dilation of the circulatory system, dehydration, can all do that. ---
**Author:** ![MichaelJohnBertrand](https://avatars.discourse-cdn.com/v4/letter/m/dfb087/32.png) [@MichaelJohnBertrand](https://boards.straightdope.com/u/MichaelJohnBertrand)\ **Post date:** [January 29, 2009, 10:19pm UTC](https://boards.straightdope.com/t/what-exactly-is-the-treatment-for-shock/483478/23 "2009-01-29T22:19:54Z")
> [@Telemark](#): > > From earlier in the thread: > > So, for a variety of possible reasons, oxygenated blood isn’t making it to the cells. Fear, by itself, usually can’t do that. Loss of blood, dilation of the circulatory system, dehydration, can all do that. Right, got it. Hmmm. Yeah, I suppose that extreme emotion might move your blood around a lot, but it’s unlikely to cause something quite that extreme. ---
**Author:** ![Rick](https://avatars.discourse-cdn.com/v4/letter/r/9f8e36/32.png) [@Rick](https://boards.straightdope.com/u/Rick)\ **Post date:** [January 30, 2009, 5:10am UTC](https://boards.straightdope.com/t/what-exactly-is-the-treatment-for-shock/483478/24 "2009-01-30T05:10:35Z")
> [@si\_blakely](#): > > While waiting for the real medics to show up… > > [Crush Syndrome](http://en.wikipedia.org/wiki/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. > > Si My father told me he was only trapped for a matter of minutes, and was almost able to climb out without help, Remember he was a young man in the Navy, presumably in good shape, and was only buried up to about his knees. It was this combo of facts that made me go 😕. ---
**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [January 30, 2009, 10:38am UTC](https://boards.straightdope.com/t/what-exactly-is-the-treatment-for-shock/483478/25 "2009-01-30T10:38:45Z")
> [@Eats\_Crayons](#): > > 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? As an ED physician, I’m the “they” so I’ll add 2c here. In answer to your specific question, for the most part, in a healthy individual, nothing, except let you chill out. One of the golden rules for doctors in this sort of situation is, “Don’t just do something. Stand there.” QtM put in a nice post about the way we use the term “shock” in medicine, and as he points out subsequently, what the news media call “shock” is a more colloquial use. The bystanders have had a response commonly referred to as the “Fright, Flight or Fight Resonse” or some equivalent. Here’s a Wiki summary: [Fight-or-flight response - Wikipedia](http://en.wikipedia.org/wiki/Fight-or-flight_response) It is essentially a response to adrenaline and its fellow catecholamines, and nearly always resolves as the stimulus trigger and the circulating stress hormones wear off. Of course nothing in medicine is always, so in rare instances a patient might need a little chilling-out medicine (a benzodiazepene, perhaps) to get them to relax. There are specific antagonists to block the effects of too much adrenaline (beta blockers, e.g.), but here again the golden rule should usually apply: do nothing before you go treating a self-limited condition. Sometimes really nervous people hyperventilate so much their carbon dioxide level drops too far and they get the tinglies from that (it drops their ionized calcium levels and can cause twitching, muscle spasm and so on). We’ll work with them to slow their breathing down or give them a chore such as breathing into a paper bag–if they do it right, re-breathing their own exhaled air can help restore their CO2 to normal. Finally, of course, there is that extremely rare poor soul for whom a big release of catecholamines is fatal. Crappy heart valve that has gone undiagnosed; unrecognized intracerebral aneurysm that blows when the blood pressure spikes; sensitive myocardial cell that triggers ventricular fibrillation–some condition that genuinely couldn’t handle the physiologic shock at the unexpected beheading. It’s not all that rare for a geezer like me to have underlying coronary artery disease and drop dead at the shock of finding out Cecil was wrong or Aunt Bessie died or the like. Whether the event or the underlying cause should be blamed is a matter of semantics, I suppose. The newspaper is gonna blame the event and the pathologist the coronary artery disease. Figuring out which is which is why I get paid, and why we pretend taking care of all the normals to find the one zebra is “treatment” when it’s really just observation. ---
**Author:** ![Chief\_Pedant](https://avatars.discourse-cdn.com/v4/letter/c/a6a055/32.png) [@Chief\_Pedant](https://boards.straightdope.com/u/Chief_Pedant)\ **Post date:** [January 30, 2009, 10:56am UTC](https://boards.straightdope.com/t/what-exactly-is-the-treatment-for-shock/483478/26 "2009-01-30T10:56:52Z")
> [@Chief\_Pedant](#): > > Finally, of course, there is that extremely rare poor soul for whom a big release of catecholamines is fatal. Crappy heart valve that has gone undiagnosed; unrecognized intracerebral aneurysm that blows when the blood pressure spikes; sensitive myocardial cell that triggers ventricular fibrillation–some condition that genuinely couldn’t handle the physiologic shock at the unexpected beheading. It’s not all that rare for a geezer like me to have underlying coronary artery disease and drop dead at the shock of finding out Cecil was wrong or Aunt Bessie died or the like. Whether the event or the underlying cause should be blamed is a matter of semantics, I suppose. The newspaper is gonna blame the event and the pathologist the coronary artery disease. For example, this poor woman scared to death by a robber: [http://www.msnbc.msn.com/id/28917619/?gt1=43001](http://www.msnbc.msn.com/id/28917619/?gt1=43001) Just happened to be a frontpage [MSN.com](http://MSN.com) story I saw upon returning to my regular routine. Looks like the law comes down on the side of blaming the precipitating event. [Previous page](https://boards.straightdope.com/t/what-exactly-is-the-treatment-for-shock/483478.md?page=1)