Shock, Physical

Medical, or, Psychological

Symptoms, Coping, Treatments

What you don't know, could kill or disable you.

      INDEX
    • Shock: Description.
    • Shock: Acute Stress Reaction.
    • Shock: Post Traumatic Stress Disorder (PTSD).

    • Shock: Causes; Types.
    • Shock: Symptoms; Indicators.
    • Shock: Treatments, Medical.
    • Shock: Treatments, Self & Home.
    • Shock: Prevention.
    • Shock: Ballistic Trauma.

    • Shock: LINKS to Resources.
    • Shock: Chronic Moderated Response.

    • -Focus-: Monographs on Toxins and Enhancers.



Shock: Description. INDEX

Shock can be a life-threatening medical condition as a result of insufficient blood flow throughout the body.

Clinical shock is a potentially severe physical reaction to an injury or another medical emergency.

Emotional shock is the mental distress that can occur after a sudden traumatic or upsetting event.
These can include experiences such as receiving news of death of a significant person, job loss, being physically attacked, slander or defamation about oneself, or, losing one's residence or a prized possession.

The shock index (SI), defined as heart rate divided by systolic blood pressure, is an accurate diagnostic measure that is more useful than hypotension and tachycardia in isolation. Under normal conditions, a number between .5 and .8 is typically seen. Should that number increase, so does suspicion of an underlying state of shock. Blood pressure alone may not be a reliable sign for shock, as there are times when a person is in circulatory shock but has a stable blood pressure

There are four stages of shock.
As it is a complex and continuous condition there is no sudden transition from one stage to the next.
At a cellular level shock is the process of oxygen demand becoming greater than oxygen supply.

Initial
During this stage, the state of hypoperfusion causes hypoxia.
Due to the lack of oxygen, the cells perform lactic acid fermentation.
Since oxygen, the terminal electron acceptor in the electron transport chain is not abundant, this slows down entry of pyruvate into the Krebs cycle, resulting in its accumulation. Accumulating pyruvate is converted to lactate by lactate dehydrogenase and hence lactate accumulates (causing lactic acidosis).

Compensatory
This stage is characterised by the body employing physiological mechanisms, including neural, hormonal and bio-chemical mechanisms in an attempt to reverse the condition. As a result of the acidosis, the person will begin to hyperventilate in order to rid the body of carbon dioxide (CO2). CO2 indirectly acts to acidify the blood and by removing it the body is attempting to raise the pH of the blood. The baroreceptors in the arteries detect the resulting hypotension, and cause the release of epinephrine and norepinephrine.

Norepinephrine causes predominately vasoconstriction with a mild increase in heart rate, whereas epinephrine predominately causes an increase in heart rate with a small effect on the vascular tone; the combined effect results in an increase in blood pressure. The renin-angiotensin axis is activated, and arginine vasopressin (Anti-diuretic hormone; ADH) is released to conserve fluid via the kidneys. These hormones cause the vasoconstriction of the kidneys, gastrointestinal tract, and other organs to divert blood to the heart, lungs and brain. The lack of blood to the renal system causes the characteristic low urine production. However the effects of the renin-angiotensin axis take time and are of little importance to the immediate homeostatic mediation of shock.

Progressive
Should the cause of the crisis not be successfully treated, the shock will proceed to the progressive stage and the compensatory mechanisms begin to fail. Due to the decreased perfusion of the cells, sodium ions build up within while potassium ions leak out. As anaerobic metabolism continues, increasing the body's metabolic acidosis, the arteriolar smooth muscle and precapillary sphincters relax such that blood remains in the capillaries. Due to this, the hydrostatic pressure will increase and, combined with histamine release, this will lead to leakage of fluid and protein into the surrounding tissues.

As this fluid is lost, the blood concentration and viscosity increase, causing sludging of the micro-circulation.
The prolonged vasoconstriction will also cause the vital organs to be compromised due to reduced perfusion. If the bowel becomes sufficiently ischemic, bacteria may enter the blood stream, resulting in the increased complication of endotoxic shock.

Refractory
At this stage, the vital organs have failed and the shock can no longer be reversed.
Brain damage and cell death are occurring, and death will occur imminently.
One of the primary reasons that shock is irreversible at this point is that much cellular ATP has been degraded into adenosine in the absence of oxygen as an electron receptor in the mitochondrial matrix. Adenosine easily perfuses out of cellular membranes into extracellular fluid, furthering capillary vasodilation, and then is transformed into uric acid. Because cells can only produce adenosine at a rate of about 2% of the cell's total need per hour, even restoring oxygen is futile at this point because there is no adenosine to phosphorylate into ATP.



Shock: Acute Stress Reaction. INDEX
(This is also referred to as "Shell Shock," "Post Traumatic Stress Disorder" (PTSD), and, "Emotional" Shock.

Common symptoms that sufferers of acute stress disorder experience are:

    • numbing;
    • emotional detachment;
    • muteness;
    • derealization;
    • depersonalization;
    • psychogenic amnesia;
    • continued re-experiencing of the event via
      thoughts,
      dreams, and
      flashbacks; and
      avoidance of any stimulation that reminds them of the event.

During this time, they must have symptoms of anxiety, and significant impairment in at least one essential area of functioning.
Symptoms last for a minimum of 2 days, and a maximum of 4 weeks, and occur within 4 weeks of the event.

Acute stress disorder (abbreviated ASD) is the result of a traumatic event in which the person experiences or witnesses an event that causes the victim/witness to experience extreme, disturbing, or unexpected fear, stress, or pain, and that involves or threatens serious injury, perceived serious injury, or death to themselves or someone else. A study of rescue personnel after exposure to a traumatic event showed no gender difference in acute stress reaction. Acute stress reaction is a variation of post-traumatic stress disorder (PTSD).

The onset of a stress response is associated with specific physiological actions in the sympathetic nervous system, both directly and indirectly through the release of adrenaline and to a lesser extent noradrenaline from the medulla of the adrenal glands. These catecholamine hormones facilitate immediate physical reactions by triggering increases in heart rate and breathing, constricting blood vessels. An abundance of catecholamines at neuroreceptor sites facilitates reliance on spontaneous or intuitive behaviors often related to combat or escape.

Normally, when a person is in a serene, unstimulated state, the "firing" of neurons in the locus ceruleus is minimal.
A novel stimulus, once perceived, is relayed from the sensory cortex of the brain through the thalamus to the brain stem.
That route of signaling increases the rate of noradrenergic activity in the locus ceruleus, and the person becomes alert and attentive to the environment.

If a stimulus is perceived as a threat, a more intense and prolonged discharge of the locus ceruleus activates the sympathetic division of the autonomic nervous system (Thase & Howland, 1995). The activation of the sympathetic nervous system leads to the release of norepinephrine from nerve endings acting on the heart, blood vessels, respiratory centers, and other sites. The ensuing physiological changes constitute a major part of the acute stress response. The other major player in the acute stress response is the hypothalamic-pituitary-adrenal axis.

During the early stages of World War I, soldiers from the British Expeditionary Force began to report medical symptoms after combat, including tinnitus, amnesia, headache, dizziness, tremor, and hypersensitivity to noise. While these symptoms resembled those that would be expected after a physical wound to the brain, many of those reporting sick showed no signs of head wounds. By December 1914 as many as 10% of British officers and 4% of enlisted men were suffering from "nervous and mental shock".

The term "shell shock" came into use to reflect an assumed link between the symptoms and the effects of explosions from artillery shells. The term was first published in 1915 in an article in The Lancet by Charles Myers. Some 60-80% of shell shock cases displayed acute neurasthenia, while 10% displayed what would now be termed symptoms of conversion disorder, including mutism and fugue.

The number of shell shock cases grew during 1915 and 1916 but it remained poorly understood medically and psychologically.
Some doctors held the view that it was a result of hidden physical damage to the brain, with the shock waves from bursting shells creating a cerebral lesion that caused the symptoms and could potentially prove fatal. Another explanation was that shell shock resulted from poisoning by the carbon monoxide formed by explosions.

At the same time an alternative view developed describing shell shock as an emotional, rather than a physical, injury.
Evidence for this point of view was provided by the fact that an increasing proportion of men suffering shell shock symptoms had not been exposed to artillery fire. Since the symptoms appeared in men who had no proximity to an exploding shell, the physical explanation was clearly unsatisfactory.

At first, shell-shock casualties were rapidly evacuated from the front line -- in part because of fear of their unpredictable behaviour.
As the size of the British Expeditionary Force increased, and manpower became in shorter supply, the number of shell shock cases became a growing problem for the military authorities. At the Battle of the Somme in 1916, as many as 40% of casualties were shell-shocked, resulting in concern about an epidemic of psychiatric casualties, which could not be afforded in either military or financial terms. ...

During 1917, "shell shock" was entirely banned as a diagnosis in the British Army, and mentions of it were censored, even in medical journals. ...

There were so many officers and men suffering from shell shock that 19 British military hospitals were wholly devoted to the treatment of cases. Ten years after the war, 65,000 veterans of the war were still receiving treatment for it in Britain. In France it was possible to visit aged shell shock victims in hospital in 1960.

War correspondent Philip Gibbs wrote:

Something was wrong. They put on civilian clothes again and looked to their mothers and wives very much like the young men who had gone to business in the peaceful days before August 1914. But they had not come back the same men. Something had altered in them. They were subject to sudden moods, and queer tempers, fits of profound alternating with a restless desire for pleasure. Many were easily moved to passion where they lost control of themselves, many were bitter in their speech, violent in opinion, frightening.



Shock: Post Traumatic Stress Disorder (PTSD). INDEX
http://www.bullyonline.org/stress/ptsd.htm
Updated 4 November 2005

"When the trauma is inflicted by another person, is especially intense,
or the traumatized person is extremely close to the trauma,
the severity of traumatization may be especially profound"

Robert C Scaer, MD, Author,
The Body bears the Burden: Trauma, Dissociation and Disease.


Post Traumatic Stress Disorder (PTSD) is a natural emotional reaction to a deeply shocking and disturbing experience.
It is a normal reaction to an abnormal situation.

Few people realise that trauma and psychiatric injury can be more devastating and long-lasting than physical injury.
Traumatic events strike unexpectedly turning everyday experiences upside-down and destroying the belief that "it could never happen to me".

PTSD is a natural emotional reaction to a deeply shocking and disturbing experience after which it can be difficult to believe that life will ever be the same again. The symptoms are surprisingly common and include

    • sleep problems,
    • nightmares,
    • waking early,
    • flashbacks and replays,
    • impaired memory,
    • inability to concentrate,
    • hypervigilance (feels like but is not paranoia),
    • jumpiness and an exaggerated startle response,
    • fragility and hypersensitivity,
    • detachment and avoidance behaviours,
    • depression,
    • irritability,
    • violent outbursts,
    • joint and muscle pains,
    • panic attacks,
    • fatigue,
    • low self-esteem,
    • feelings of nervousness and undue anxiety.

Survivors endure abnormal feelings of guilt, perhaps for having survived when those around them didn't.

Untreated, PTSD symptoms can last a lifetime, impairing health, damaging relationships and preventing people achieving their potential. Sufferers often find that knowledge and treatment of PTSD (and especially Complex PTSD) is difficult to obtain. However, prospects for recovery are good when you have the right counsel and are in the company of fellow survivors and those with genuine insight, empathy and experience.

Positive stress (what Abraham Maslow calls eustress) is the result of good management and excellent leadership where everyone works hard, is kept informed and involved, and - importantly - is valued and supported. People feel in control.

Negative stress (what Maslow calls distress) is the result of a bullying climate where threat and coercion substitute for non-existent management skills. When people use the word "stress" on its own, they usually mean "negative stress".

I define stress as "the degree to which one feels, perceives or believes one is not in control of one's circumstances". Control - or people's perception of being in control - seems to be key to susceptibility to experiencing PTSD.

The UK, and much of the Western world, adopts a blame-the-victim mentality as a way of avoiding having to deal with difficult issues. When dealing with stress it is essential to identify the cause of stress and work to reduce or eliminate the cause. Sending employees on stress management courses may sound good on paper but coercing people to endure more stress without addressing the cause is going to result in further psychiatric injury.

Stress is not the employee's inability to cope with excessive workload and excessive demands but a consequence of the employer's failure to provide a safe system of work as required by the Health and Safety at Work Act 1974.

Stress is known to cause brain damage.
Dr John T O'Brien, consultant in old-age psychiatry at Newcastle General Hospital, published a paper in March 1997 entitled "The glucocorticoid cascade hypothesis in man" (and presumably woman), helpfully subtitled "Prolonged stress may cause permanent brain damage". If Dr O'Brien's research proves correct, then employers who encourage stressful regimes comprising long hours, threat and coercion might soon find themselves on the wrong end of a string of expensive personal injury lawsuits.

It seems that Complex PTSD can potentially arise from any prolonged period of negative stress in which certain factors are present, which may include any of

    • captivity,
    • lack of means of escape,
    • entrapment,
    • repeated violation of boundaries,
    • betrayal,
    • rejection,
    • bewilderment,
    • confusion, and
    • - crucially - lack of control, loss of control and disempowerment.

It is the overwhelming nature of the events and the inability (helplessness, lack of knowledge, lack of support etc) of the person trying to deal with those events that leads to the development of Complex PTSD.

Situations which might give rise to Complex PTSD include

    • bullying,
    • harassment,
    • abuse,
    • domestic violence,
    • stalking,
    • long-term caring for a disabled relative,
    • unresolved grief,
    • exam stress over a period of years,
    • mounting debt,
    • contact experience, etc.

Those working in regular traumatic situations, eg the emergency services, are also prone to developing Complex PTSD.

A key feature of Complex PTSD is the aspect of captivity.
The individual experiencing trauma by degree is unable to escape the situation.
Despite some people's assertions to the contrary, situations of domestic abuse and workplace abuse can be extremely difficult to get out of. In the latter case there are several reasons, including financial vulnerability (especially if you're a single parent or main breadwinner - the rate of marital breakdown is approaching 50% in the UK), unavailability of jobs, ageism (many people who are bullied are over 40), partner unable to move, and kids settled in school and you are unable or unwilling to move them. The real killer, though, is being unable to get a job reference - the bully will go to great lengths to blacken the person's name, often for years, and it is this lack of reference more than anything else which prevents people escaping.

Common features of Complex PTSD from bullying

People suffering Complex PTSD as a result of bullying report consistent symptoms which further help to characterise psychiatric injury and differentiate it from mental illness. These include:

o Fatigue with symptoms of or similar to Chronic Fatigue Syndrome (formerly ME)

o An anger of injustice stimulated to an excessive degree (sometimes but improperly attracting the words "manic" instead of motivated, "obsessive" instead of focused, and "angry" instead of "passionate", especially from those with something to fear)

o An overwhelming desire for acknowledgement, understanding, recognition and validation of their experience

o A simultaneous and paradoxical unwillingness to talk about the bullying (click here to see why) or abuse

o A lack of desire for revenge, but a strong motivation for justice

o A tendency to oscillate between conciliation (forgiveness) and anger (revenge) with objectivity being the main casualty

o Extreme fragility, where formerly the person was of a strong, stable character

o Numbness, both physical (toes, fingertips, and lips) and emotional (inability to feel love and joy)

o Clumsiness

o Forgetfulness

o Hyperawareness and an acute sense of time passing, seasons changing, and distances travelled

o An enhanced environmental awareness, often on a planetary scale

o An appreciation of the need to adopt a healthier diet, possibly reducing or eliminating meat - especially red meat

o Willingness to try complementary medicine and alternative, holistic therapies, etc

o A constant feeling that one has to justify everything one says and does

o A constant need to prove oneself, even when surrounded by good, positive people

o An unusually strong sense of vulnerability, victimisation or possible victimisation, often wrongly diagnosed as "persecution"

o Occasional violent intrusive visualisations

o Feelings of worthlessness, rejection, a sense of being unwanted, unlikeable and unlovable

o A feeling of being small, insignificant, and invisible

o An overwhelming sense of betrayal, and a consequent inability and unwillingness to trust anyone, even those close to you

o In contrast to the chronic fatigue, depression etc, occasional false dawns with sudden bursts of energy accompanied by a feeling of "I'm better!", only to be followed by a full resurgence of symptoms a day or two later

o Excessive guilt - when the cause of PTSD is bullying, the guilt expresses itself in forms distinct from "survivor guilt"; it comes out as:

- an initial reluctance to take action against the bully and report him/her knowing that he/she could lose his/her job later, this reluctance gives way to a strong urge to take action against the bully so that others, especially successors, don't have to suffer a similar fate

- reluctance to feel happiness and joy because one's sense of other people's suffering throughout the world is heightened

- a proneness to identifying with other people's suffering

- a heightened sense of unworthiness, undeservingness and non-entitlement (some might call this shame)

- a heightened sense of indebtedness, beholdenness and undue obligation

- a reluctance to earn or accept money because one's sense of poverty and injustice throughout the world is heightened

- an unwillingness to take ill-health retirement because the person doesn't want to believe they are sufficiently unwell to merit it

- an unwillingness to draw sickness, incapacity or unemployment benefit to which the person is entitled

- an unusually strong desire to educate the employer and help the employer introduce an anti-bullying ethos, usually proportional to the employer's lack of interest in anti-bullying measures

- a desire to help others, often overwhelming and bordering on obsession, and to be available for others at any time regardless of the cost to oneself

- an unusually high inclination to feel sorry for other people who are under stress, including those in a position of authority, even those who are not fulfilling the duties and obligations of their position (which may include the bully) but who are continuing to enjoy salary for remaining in post [hint: to overcome this tendency, every time you start to feel sorry for someone, say to yourself "sometimes, when you jump in and rescue someone, you deny them the opportunity to learn and grow"]


Fatigue
The fatigue is understandable when you realise that in bullying, the target's fight or flight mechanism eventually becomes activated from Sunday evening (at the thought of facing the bully at work on Monday morning) through to the following Saturday morning (phew - weekend at last!). The fight or flight mechanism is designed to be operational only briefly and intermittently; in the heightened state of alert, the body consumes abnormally high levels of energy. If this state becomes semi-permanent, the body's physical, mental and emotional batteries are drained dry. Whilst the weekend theoretically is a time for the batteries to recharge, this doesn't happen, because:

* the person is by now obsessed with the situation (or rather, resolving the situation), cannot switch off, may be unable to sleep, and probably has nightmares, flashbacks and replays;

* sleep is non-restorative and unrefreshing - one goes to sleep tired and wakes up tired

* this type of experience plays havoc with the immune system; when the fight or flight system is eventually switched off, the immune system is impaired such that the person is open to viruses which they would under normal circumstances fight off; the person then spends each weekend with a cold, cough, flu, glandular fever, laryngitis, ear infection etc so the body's batteries never have an opportunity to recharge.


When activated, the body's fight or flight response results in the digestive, immune and reproductive systems being placed on standby. It's no coincidence that people experiencing constant abuse, harassment and bullying report malfunctions related to these systems (loss of appetite, constant infections, flatulence, irritable bowel syndrome, loss of libido, impotence, etc). The body becomes awash with cortisol which in high prolonged doses is toxic to brain cells. Cortisol kills off neuroreceptors in the hippocampus, an area of the brain linked with learning and memory. The hippocampus is also the control centre for the fight or flight response, thus the ability to control the fight or flight mechanism itself becomes impaired.

Most survivors of bullying experience symptoms of Chronic Fatigue Syndrome.

Associated symptoms of Complex PTSD

Survivor guilt: survivors of disasters often experience abnormally high levels of guilt for having survived, especially when others - including family, friends or fellow passengers - have died. Survivor guilt manifests itself in a feeling of "I should have died too". In bullying, levels of guilt are also abnormally raised. The survivor of workplace bullying may have develop an intense albeit unrealistic desire to work with their employer (or, by now, their former employer) to eliminate bullying from their workplace. Many survivors of bullying cannot gain further employment and are thus forced into self-employment; excessive guilt may then preclude the individual from negotiating fair rates of remuneration, or asking for money for services rendered. The person may also find themselves being abnormally and inappropriately generous and giving in business and other situations.

Shame, embarrassment, guilt, and fear are encouraged by the bully, for this is how all abusers - including child sex abusers - control and silence their victims.

Marital disharmony: the target of bullying becomes obsessed with understanding and resolving what is happening and the experience takes over their life; partners become confused, irritated, bewildered, frightened and angry; separation and divorce are common outcomes.

Transformation

A stress breakdown is a transformational experience which, with the right support, can ultimately enrich the experiencer's life. However, completing the transformation can be a long and sometimes painful process. The Western response - to hospitalise and medicalize the experience, thus hindering the process - may be well-intentioned, but may lessen the value and effectiveness of the transformation.

How would you feel if, rather than a breakdown, you viewed it as a breakthrough?
How would you feel if it was suggested to you that the reason for a stress breakdown is to awaken you to your mission in life and to enable you to discover the reason why you have incarnated on this planet? How would it change your view of things if it was also suggested to you that a stress breakdown reconfigures your brain to enable you to embark on the path that will culminate in the achievement of your mission?



Shock: Causes; Types. INDEX

The causes of clinical shock include serious accident, severe allergic reaction, burns, heart attack etc.

There are several types of shock:
septic shock caused by bacteria,
anaphylactic shock caused by hypersensitivity or allergic reaction,
cardiogenic shock from heart damage,
hypovolemic shock from blood or fluid loss, and
neurogenic shock from spinal cord trauma.

Dehydration: Burns, Persistent vomiting, diarrhea; similar to Hypovolemic shock.

Septic shock results from bacteria multiplying in the blood and releasing toxins.
Common causes of this are pneumonia, urinary tract infections, skin infections (cellulitis), intra-abdominal infections (such as a ruptured appendix), and meningitis.

Anaphylactic shock is a type of severe hypersensitivity or allergic reaction.
Causes include allergy to insect stings, medicines, or foods (nuts, berries, seafood), etc.

Cardiogenic shock happens when the heart is damaged and unable to supply sufficient blood to the body. This can be the end result of a heart attack or congestive heart failure.

Hypovolemic shock is caused by severe blood and fluid loss, such as from traumatic bodily injury, which makes the heart unable to pump enough blood to the body, or severe anemia where there is not enough blood to carry oxygen through the body.

Neurogenic shock is caused by spinal cord injury, usually as a result of a traumatic accident or injury.

Endocrine shock is the result of endocrine disturbances such as:

Hypothyroidism ... reduces cardiac output and can lead to hypotension and respiratory insufficiency.

Thyrotoxicosis (Cardiogenic shock) ... may induce a reversible cardiomyopathy.

Acute adrenal insufficiency (Distributive shock) ... (in adrenally overactive elevated stress demand persons).

Relative adrenal insufficiency (Distributive shock) ... (in adrenally overactive elevated stress demand persons).



Shock: Symptoms; Indicators. INDEX

Shock results in sudden fall in the body's circulating blood volume, which leads to a reduction in amount of oxygen reaching the brain and other vital organs.

The symptoms of clinical shock include

    • rapid and shallow breathing,
    • grey or pale skin,
    • cold and sweaty skin,
    • rapid, weak and irregular pulse rate,
    • dizziness,
    • fainting,
    • thirst,
    • nausea and
    • vomiting etc.

Only one or several symptoms may present in an obvious manner.

Lack of oxygen in the body's tissues (hypoxia), will place intense stress on the Heart and can result in heart attack (cardiac arrest) or organ damage.

OTHER symptoms include these: 

Seizures 
Sweating 
Chest pain
Eyes appear to stare 
Anxiety or agitation 
Low or no urine output 
Confusion or unresponsiveness 
Bluish lips and fingernails; cold extremities. 
Distended jugular veins due to increased jugular venous pressure
Weak or absent pulse
Arrhythmia, often tachycardia
Pulsus paradoxus in case of tamponade

While a fast heart rate is common, those on Beta-blockers, those who are athletic and in 30% of cases those with shock due to intra abdominal bleeding may have a normal or slow heart rate.



Shock: Treatments, Medical. INDEX

    • One of the key dangers of shock is that it progresses by a positive feedback mechanism.
      Poor blood supply leads to cellular damage, which in turn triggers tissues around the body to become inflamed and inhibit perfusion around the body. Because of this, immediate treatment of shock is critical to the survival of the sufferer.

    • In general, fluid resuscitation (giving a large amount of fluid to raise blood pressure quickly) with an IV in the ambulance or emergency room is the first-line treatment for all types of shock.

    • Medications to raise one's blood pressure, such as epinephrine, norepinephrine, or dopamine ... to ensure blood flow to the vital organs.

    • Septic shock is treated with broad spectrum and organism specific antibiotics, and, fluids.
      Main manifestations are produced due to massive release of histamine which causes intense vasodilation.
      Patients with septic shock will also likely be positive for the SIRS Criteria.

    • Anaphylactic shock is treated with diphenhydramine (Benadryl), epinephrine (an "Epi-pen"), and steroid medications .. methylprednisolone (Solu-Medrol), and sometimes a H2-Blocker medication (for example, famotidine [Pepcid], cimetidine [Tagamet], etc.).

    • Hypovolemic shock is treated with fluids (saline) in minor cases, and blood transfusions in severe cases.

    • Neurogenic shock is the most difficult to treat as spinal cord damage is often irreversible.
      Besides fluids and monitoring, immobilization (keeping the spine from moving), anti-inflammatory medicine such as steroids, and sometimes surgery are often parts of treatment.

    • Cardiogenic shock is treated by identifying and treating the underlying cause.
      A patient with a heart attack may require a surgical procedure called a cardiac catheterization to unblock an artery.
      A patient with congestive heart failure may need medications to support and increase the force of the heart's beat. In severe or prolonged cases, a heart transplant may be the only medical treatment considered.



Shock: Treatments, Self & Home. INDEX

    • Homeopathics:
      Use Bach Rescue Remedy and/or other indicated essences & homeopathics.
      Carry an AID kit with you for any known and likely mishaps, occurrences, ....

    • Essential Oils: Use lavender oil, geranium oil, chamomile oil, valerian oil, jojoba oil etc.

    • Beverages, Teas:
      Herbal tea made of elderflowers or rosemary, chamomile, lemon balm; fenugreek and ginger teas; perhaps coffees.
      CAUTION: If the person appears to be near to experiencing unconsciousness, do not give fluids by mouth, even if the person complains of thirst .. as the person may choke if they lose consciousness, and, minimize oxygen intake.

    • Breathing: check the person's airway, breathing and circulation (the ABCs).
      Administer CPR if you are trained. If the person is breathing on his or her own, continue to check breathing every 2 minutes until help arrives.

    • Heart Assistance:
      administer external heart massage and ensure that the person does NOT hold their breath (which exerts pressure on the heart and depresses its function).

    • Heart relief: reduce demand on the heart through positioning and reduced activity:
      lie down on the back with the feet elevated above the head (if raising the legs causes pain or injury, keep the person flat) to increase blood flow to vital organs. Do not raise the head. Keep the person warm and comfortable. Loosen tight clothing and cover them with a blanket.

    • Reduce Fluid Loss: apply Direct pressure to any wounds that are bleeding significantly.
      Assure Calm and hopefulness to minimize urine loss due to intense fear or panic.



Shock: Prevention. INDEX

Shock prevention includes learning ways to prevent heart disease, injuries, dehydration and other causes of shock.

    • Pregnancy: Avoid conflicts and frustrations, anger and intensities.

    • Environment: maintain a temperate and moderate humidity surrounding indoors and out.

    • Energy Blocks: release in order to avoid Reactive extremes of fear, paranoia, ....

    • Anti-Panic modeling: learn confidence in problem solving and pre-planning.

    • Strength and Stamina: build adequate physical resources (muscle mass, flexibility, leanness, awareness) and take adequate rest to minimize tiredness.

    • Nutrition: maintain vitamin (B's) and mineral (zinc) levels while minimizing calories.

    • Breath Training: Yoga breathing exercises (anti-panic), meditation, progressive relaxation exercises, Tai Chi, QiGong,

    • Reptilian Structure Movement reorientation:
      There may be a necessity and benefit in defining and relearning movement protocols which have been distorted and minimized to address perceived earlier urgencies and extremes, yet, result in endemic patterns of tension, energy waste, stiffness, and, pain.



Shock: Ballistic Trauma. INDEX
Gunshot Wound Medical Concerns.
by James Hubbard, M.D., M.P.H.

A paramedic told me that when she was in training, a patient came in who had been shot in the right upper chest.
They ended up finding the bullet not in the back, not even in the other side of the chest, but way down in the right butt cheek, pushing against the skin.

In most circumstances, you don't want to remove an implanted bullet.
It's almost impossible to find, and it may actually be corking up a big blood vessel.

Thousands of military members live daily with shrapnel in their bodies.
Unless there's initial infection from the wound itself, the body adapts to most metal without much serious problem.

The mass media (movies, plays, books, photos, songs, stories) have purveyed the objectification and dissociation myths of the sudden death bullet wound from the early 1900's, or before, to this day (2015). The destructiveness of this form of myth is that in an attempt to provide an understanding of and an acceptance of a healthfully shocking incident ... it actually "prepares" the innocent to be traumatized when they are exposed to a REAL incident. This has resulted in many soldiers and civilians adopting PTSD in any war or physical conflict, since 1929. Moreover, this is almost exclusively relegated to those who have been "educated" and imprinted in industrial, commercial, and technology driven cultures afforded with mass media entertainment-distraction.

    A few FACTS can prepare one to Accept and Adjust to the REALITIES which gunshot wound experiences and observations may present:

    • Most people do NOT die within 4 minutes from a gunshot wound, and, NEVER, immediately.

    • Persons who die in less than an hour from a gunshot wound die from blood loss, usually resulting from the cutting damage effected by the path of a bullet through an organ, artery, or vein.

    • Persons who die after durations longer than an hour frequently die from sepsis .. various forms of infection .. which may be introduced into the body by the bullet, by the environment surrounding the wound, or, by the perforation of the bowel of the injured.

    • Muscle and other tissue within the injured have in some cases, acted to close the wound and stop blood loss.
      A WWI veteran survived with a bullet in his heart tissue and was unaware of its presence until an x-ray revealed it 40 years later. A New York City policeman was shot in the heart and remained conscious and calm for 40 minutes, by which time he had reached a hospital and was treated.

    • Deaths from bullets are quicker and more certain when they enter the body and severe critical nerves to result in a depression of or cessation of fundamental body activities, such as brain or heart function.

    • The extensiveness (leathalness) of a particular projectile (bullet, shrapnel, fragment, stone) is a combination of its size, weight, design/shape, composition, speed, destination. "Small" bullets can do more damage than some larger ones. Projectiles can change shape, direction, and/or fragment AFTER entering a body or other physical mass, and depending upon whether they strike and fracture, break, or glance from a bone or other high density structure. There are few certainties of an outcome beyond that of wounding.

  • The BEST prevention of shock is to avoid higher risk and conflict environments.

  • A BETTER-than-average prevention of shock is Preparation through Awareness from research, planning, experience, feedback ... of what REALISTICALLY often happens, and how one can influence the outcomes.

  • A GOOD prevention of shock is to adopt patterns of awareness, attitude, and behavior which encourage harmony, positive self-esteem, self-sufficiency, and, spiritual strengths.

  • A POOR resistance to shock is to remain unaware of the possibilities of injuries, death, and loss which are present in whatever environment one is in, chooses to be in, or becomes exposed to.

  • The WORST preparation for shock are the fantasy and well-intentioned lies which one may hear from authoritative and sanctioned sources which encourage the person to willfully invite risk and injury through pride, a desire for acceptance, an over-optimistic projection of outcomes, a reaction to chronic frustration or anxiety, or, a desire to effect action/violence resourced from intensity or hatred.



Shock: LINKS to Resources. INDEX


Shock: Chronic Moderated Response. INDEX

This type of Shock is established pre-birth and results in specific physiological tendencies during the life of the person which may be elevate or decreased in presence and intensity by attitude, behavior, and routine training, imprinting, and, coaching ... usually derived from personal choice. Cultural norms frequently do NOT encourage these changes for the masses as they are only significantly relevant for less than 2% of the population.

The source of the initial shock PROCESS can be understood as either SUDDEN (as in the case of a pre-mature, aborted, or, emergency birth), or, as REACTIVE (as in the case of a life threatening threshold of toxins being reached which may accumulate in the mother ... from bacterial, fungal, or heavy metal poisons; hormonal imbalances from destructive emotional intensities; physiological shock realities of injuries which threaten fatality). BOTH apply with the Reactive building to a point of Sudden resolution. At that stage, birth, the Reptilian Structure of the infant has adopted a normative threshold of "balance" which STRONGLY posits a number of Shock symptoms. Low blood pressure is the common factor.

This Chronic Moderated Response (CMR) of persistent pre-shock presence leaves the individual with PHYSICAL characteristics which encourage and make easier/safer some forms of activities-behaviors than are best for the majority of humans, and, make some forms of activities-behaviors more difficult/dangerous than experienced by the norm of humanity. Examples of these are as follows: 

       Easier/Safer than for the Norm       More Difficult/Dangerous than for the Norm
                 Change                                    Routine 
              Independence                      Social Membership, Peers, Teams 
    Dynamic/Active Meditation-Prayer            Static/Passive Meditation-Prayer
    (Tai Chi, QiGong, Martial Arts)             (Yoga, Catechisms, Recitations)
           additional Salt                     reduced or restricted Salt intake 
     More protein, fat, supplements          More carbohydrates, fruits, vegetables
       Hopefulness - Opportunities             Obligations - Regulations - Limits 
               Moderation                                 Addictions

CMR individuals may be culturally encouraged/rewarded to opt for the more Difficult/Dangerous (for them) norms which will weaken and challenge their immunity, emotions, safety, relationships, metabolism, awareness, and self-esteem. They may learn by coaching, trial-and-error, rejection, chronic health scenarios, Spiritual Guidance, or, reactionism .. to set aside the Sanctioned NORMS for the Healthful Relevancies, or, NOT.

The PHYSICAL dynamics of the Chronic Moderated Response (CMR) individual, when adapted best, differ from the normative person as follows.

Initial
During this (persistent) stage, a state of hypoperfusion and hypoxia is delayed and minimized by an increase in physical and mental activity, either/and constant or intense. This increases oxygen uptake with an added context of aggressiveness. One is involved in more activities than the norm which will include mental and emotional sensitivities, as well as both solitary and social/work interactions. Altogether, the Reptilian Structure of the CMR individual will tend to increase the efficiency of the uptake of oxygen in the lungs and its efficient transport through the body, while reducing the efficiency of the metabolism. To avoid digestive imbalances, the CMR individual will require a higher-than-average supplementation of minerals, vitamins, probiotics, and perhaps enzymes.

Fundamental Basic Personality characteristics are often modified by the combined psychological and physical dynamic to result in a lifelong base level, or, threshold, of attitudes projected through Values and Behaviors ... as detailed in the PTSD Excessive Guilt symptoms, noted above. These form a focus for the enhancement of Positive Personality traits, or, Strengths, and, a foil for the discernment of and management of one's Negative Personality traits, that is, Weaknesses.

Without these adjustments being optimized, the CMR individual is likely to experience reoccurrences of periods of illness, weakness, confusion, depression, muscle tension, headaches, pain and joint stiffness and pains, and, identity confusion ... all side effects of a rising level of lactic acid fermentation and acidosis. Additional endorphins can be released by one learning to "relax" to the pains and "accept" both them and the many disappointments which seem to arise. If the CMR individual is to survive with any degree of good health, attitude and behavior adjustments to such embedded levels of Shock/Stress can result in an alkaline balanced physiology supported by higher than average levels of endorphins.

Compensatory
For the Chronic Moderated Response (CMR) individual, this stage is fluidly entered, exited, and re-entered on an almost daily basis.
Until, and IF, the CMR individual can make enough modifications in their Attitudes and Behaviors to swing them beyond the limits of the human norms, this stage of Anxiety, Tension, Distress, Depression, Acting Out, Pain, Desperation, and Violence .. will continue to reappear and be re-experienced.

This stage is characterised by one's Reptilian Structure employing physiological mechanisms, including neural, hormonal and bio-chemical mechanisms in an attempt to reverse the condition. As a result of the acidosis, the person may hyperventilate (in fear, paranoia, panic attacks, anger) in order to rid the body of carbon dioxide (CO2). CO2 indirectly acts to acidify the blood and by removing it the body is attempting to raise (alkalize) the pH of the blood. The baroreceptors in the arteries detect the resulting hypotension, and cause the release of epinephrine and norepinephrine.

Norepinephrine causes predominately vasoconstriction with a mild increase in heart rate, whereas epinephrine predominately causes an increase in heart rate with a small effect on the vascular tone; the combined effect results in an increase in blood pressure. For the CMR dominated individual, these changes tend, as an alternative to hyperventilation, to increase the CONFLICT responses in the person (arguing, yelling, swearing, dramatic movements) .. which may be offset by learned, chosen, or reactive behaviors of passivity, withdrawal (apology, guilt, shame, prayer, reading, study, spectating, ritual ... cooking, cleaning, buying, driving, working, ...), or, displacement (involvement with others ... sports, games, clubs). These BEHAVIORS, whether active or passive, or displaced ... increase the oxygen uptake and avoid or limit the usual shock induced release of anti-diuretic hormones. Nevertheless, blood, oxygen, and activity .. is redirected, in part, from the digestive organs to the heart, lungs, brain, skin, and muscles. The result is to sustain a long-term depression of digestive function with subtle to obvious problems being maintained.

Progressive
This stage of Shock is never reached by the adapted CMR individual.
For those failing to make the beneficial adjustments in Attitude and Behavior, they will likely die from one or more chronic (often autoimmune) illnesses, an acute disease (cardiovascular or cancer), a psychological break from reality, significant accident injuries, or, peer-induced addiction .. by the age of 40 (2015). At some point, they will have crossed over the threshold into this stage, and, this quickly becomes a no-return terminal outcome.

Refractory
For the CMR individual, this stage is a redundant option.


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