question about shock

[gib65]

My question is tow-fold:

 

1) What are some typical stressors on the body that can cause it to go into shock?

 

2) What are the typical symptoms of shock?

[timo]

1)Typical physical causes are heavy loss of blood, insufficient pumping volume of the heart (cardiogenic shock) and expansion of the arteries and veins.

 

2) Symptoms depends on the form of shock. For emergency medicine (shock is an emergency situation) the two most important criteria for determining a shock (after the criterion which is almost always the most important: General appearance of the patient and a gut feeling of the medical personal) are low blood pressure and increased pulse (the latter might not be the case for cardiogenic shocks). Other symptoms include paleness and anxios behaviour (the latter is -to my experience- a useless criterion but usually mentioned). An interesting symptom of a cardiogenic shock is the swelling of the neck veins.

 

Note: While I have some basic education about such things, my memory is a bit rusty (it's been something like 5 years since I last had to deal with such things). I think googling for a good reliable webpage might be better than asking such questions on an internet forum.

[Revenged]

also allergy with anaphylatic shock...

[gib65]

the two most important criteria for determining a shock ... are low blood pressure and increased pulse.

 

That sounds like an oxymoron. Doesn't an increase in pulse increase blood pressure?

 

I think googling for a good reliable webpage might be better than asking such questions on an internet forum.

 

Doing this too.

 

Is shivering or a sense of coldness a symptom of shock?

[timo]

Doesn't an increase in pulse increase blood pressure?

I should note that with "pulse", I meant the frequency with which the heart throws out blood - I'll call it "heart rate" from here on and use the term "pulse" to mean a single pressure wave (that also transports blood) travelling through the arteries and veins.

First of all: Blood pressure is usually characterized by two values, the diastolical value which is kind of the base value, and the systolical value which is the maximum value reached when a pulse travels through the arteries. Assume you'd increase the heart rate and leave all other parameters constant. Why would that increase either the base value or the amplitude a single pulse has? I'd assume (ok, effectively I demanded it) that the blood pressure remains the same while the volume of blood rotation is increased. Effectively, the increase of heart rate can be a reaction of the body to an insufficient pumping volume of a single pulse - what the body ultimately needs is a sufficient supply of oxygen via blood, blood pressure, heart rate, volume of a single pulse etc. are just parameters which influence this in a non-trivial way. The definition of a shock in fact is (something like, better look it up somewhere) an insufficient supply of oxygen to vital organs.

 

Afaik, the increased heart rate is a typical reaction of the body which tries to compensate for the insufficient supply of oxygen. A cardiogenic shock must not necessarily result in increased heart rate - it's caused by a disfunction of the heart in the first place.

 

Blood pressure is mostly dependent on the amount of blood available and the volume of the arteries and veins (btw, which is the english common name for both, arteries and veins?). The anaphylactic shock Revenged mentioned afaik is the result of an increase of volume of arteries and veins due to an allergic reaction.

Is shivering or a sense of coldness a symptom of shock?

Counter-question first: Why are you asking these questions and what do you need/want the answers for?

It might or might not be symptoms - I just don't know. For practical reasons, these symptoms alone (i.e. without any of the others I mentioned) would rather induce me to give the patient a blanket and transport him to a warm place than to lay him down into shock position or applying infusions.

[gib65]

Counter-question first: Why are you asking these questions and what do you need/want the answers for?

 

Because this sometimes happens to me when I smoke marijuana. If it's really intense, I start feeling cold. There's also the increased heart rate and retention of water, and so I sometimes get paranoid that my body is going into shock in response to these changes. I usually tell myself that it's just paranoia and I should just not worry, but it's hard to convince myself of this when I have absolutely no knowledge of physiology.

[iNow]

Because this sometimes happens to me when I smoke marijuana. If it's really intense, I start feeling cold. There's also the increased heart rate and retention of water, and so I sometimes get paranoid that my body is going into shock in response to these changes. I usually tell myself that it's just paranoia and I should just not worry, but it's hard to convince myself of this when I have absolutely no knowledge of physiology.

While there may be some overlap between your experience and shock symptoms, the effect you describe is describable exactly from your hanging out with maryjane herself.

 

Check it out. When I used to smoke several years ago, I felt it too, but I'm pretty sure it's not shock (just similar output):

 

http://www.nida.nih.gov/ResearchReports/Marijuana/Marijuana3.html

Within a few minutes after inhaling marijuana smoke, an individual's heart begins beating more rapidly, the bronchial passages relax and become enlarged, and blood vessels in the eyes expand, making the eyes look red. The heart rate, normally 70 to 80 beats per minute, may increase by 20 to 50 beats per minute or, in some cases, even double.

[timo]

Apart from the obvious solution I think it's probably safe to just lay down in your bed in such a case. Afaik, there is not a single case of death caused directly by consumption of marijuana, so from the position of evaluating the immediate dangers that's probably safer than not smoking in the first place and going for a bike-ride instead (though the latter is more healthy of course). Feeling unwell at least at times should imho be an occasion to rethink the idea of smoking weed at all.

[Revenged]

I should note that with "pulse", I meant the frequency with which the heart throws out blood - I'll call it "heart rate" from here on and use the term "pulse" to mean a single pressure wave (that also transports blood) travelling through the arteries and veins.

First of all: Blood pressure is usually characterized by two values, the diastolical value which is kind of the base value, and the systolical value which is the maximum value reached when a pulse travels through the arteries. Assume you'd increase the heart rate and leave all other parameters constant. Why would that increase either the base value or the amplitude a single pulse has? I'd assume (ok, effectively I demanded it) that the blood pressure remains the same while the volume of blood rotation is increased. Effectively, the increase of heart rate can be a reaction of the body to an insufficient pumping volume of a single pulse - what the body ultimately needs is a sufficient supply of oxygen via blood, blood pressure, heart rate, volume of a single pulse etc. are just parameters which influence this in a non-trivial way. The definition of a shock in fact is (something like, better look it up somewhere) an insufficient supply of oxygen to vital organs.

 

Afaik, the increased heart rate is a typical reaction of the body which tries to compensate for the insufficient supply of oxygen. A cardiogenic shock must not necessarily result in increased heart rate - it's caused by a disfunction of the heart in the first place.

 

Blood pressure is mostly dependent on the amount of blood available and the volume of the arteries and veins (btw, which is the english common name for both, arteries and veins?). The anaphylactic shock Revenged mentioned afaik is the result of an increase of volume of arteries and veins due to an allergic reaction.

 

Cardiogenic shock is a result of the heart not getting enough oxygen and blood flows to the heart during diastole (i.e. when the heart is not contracting) and so increased heart rate and increasing blood pressure will not increase perfusion of the heart... It would decrease it and will make the cardiogenic shock worse...

 

Anapylatic shock is caused by severe bronchoconstriction due to an allergen causing a severe inflammatory responce... The airways can swell up to such an extent that they are completely blocked and it can kill...

[timo]

Cardiogenic shock is a result of the heart not getting enough oxygen and blood flows to the heart during diastole (i.e. when the heart is not contracting) and so increased heart rate and increasing blood pressure will not increase perfusion of the heart... It would decrease it and will make the cardiogenic shock worse...

Yet, my handbook on emergency medicine (which admittedly is neither the size of a handbook, not really written on a ambitious level and not exactly new - it's just the book we learned from in our training) claims heart rate in case of a cardiogenic shock is "tachycard, possibly bradycard, possibly arrythmic". That does of course not necessarily invalidate your post - heart rate could just go tachycard (increased rate) and make things worse.

[Revenged]

Yet, my handbook on emergency medicine (which admittedly is neither the size of a handbook, not really written on a ambitious level and not exactly new - it's just the book we learned from in our training) claims heart rate in case of a cardiogenic shock is "tachycard, possibly bradycard, possibly arrythmic". That does of course not necessarily invalidate your post - heart rate could just go tachycard (increased rate) and make things worse.

 

Yes, that's right... The body physiological responce to cardiac failure is to increase blood pressure and heart rate - which actually makes the heart failure worse...

 

This is why all the treatments (beta blockers, ACE inhibitors, diuretics...etc) aim to prevent the body increasing blood pressure and heart rate...

 

The exception here is digoxin... but that isn't much good...

[gib65]

I want to follow this thread up with my latest chemically induced insight. I had this "vision" of my motabolism slowing down almost to a halt. It looked so sickly, like it had collapsed and was just hanging there. My heart had to do all that it could to keep the rest of me alive. It had to pump blood through my veins with enough force to compensate for the temporary impotence my motabolism had succumb to.

 

I know this is greatly exaggerated, but is this generally how it works - pot slowing the motabolism and the heart rate increasing to compensate?