Talk:Shock (circulatory)

message: For the rather minor points above, you have reverted the whole article?  I will gladly add them in..Panthro 22:37, 28 March 2006 (UTC)
replies: text: The main reason is your deletion of parts of types of shock. Addisionian crisis is important, many doctors have missed the diagnosis and thought it was septic shock. Nomen Nescio 22:53, 28 March 2006 (UTC)
thread_title: So...

message: Can't you add these parts in? I am not going to revert it anymore, In order to resolve this dispute I have asked for a third opinion Wikipedia:Third opinion
:Mediation is always a good way to resolve disputes. Thank you. Nomen Nescio 22:54, 28 March 2006 (UTC)
replies: text: Can either of you boil this down to a specific dispute? I see you're both reverting each other's changes, but I'm not quite sure what the source of your disagreement is. Fagstein 04:12, 29 March 2006 (UTC)

text: Reread Irwin and Rippe, since I must confess my comments were based on memory and experience, and discovered a flaw in my argument. There are five types of shock. Therefore I have corrected that section to reflect what is presented in Irwin and Rippe (added note). Nomen Nescio 18:06, 29 March 2006 (UTC)
thread_title: Third Opinion

message: HI - I don't think "Endocrine Shock" should have its own heading. Its not a widely used term in clinical practice and the types of shock described therein can be reclassified into the the more recognised categories.  For instance - hypo and hyper thyroidism cause shock through thier effects on the heart - cardiogenic.  Likewise lack of cortisol causes a form of distributive shock.  Any thoughts?SkinnyB 22:32, 7 June 2006 (UTC)
replies: text: Although you are correct that it is not well-known, please consider the fact that this is the classification offered by Irwin and Rippe. Since that Textbook is to intensive care medicine what the Harrison is to internal medicine I think we should adopt their view.Nomen NescioGnothi seauton 11:09, 8 June 2006 (UTC)
thread_title:  Dead Horse? 

message: Disease Infobox restored. I assume it was removed along with vandalism on 6/10. The infobox template provides a compact set of references and links - it may not be self-evident yet but is being refined - see Template_talk:Infobox_Disease#Suggestion Finavon 20:54, 9 October 2006 (UTC)
thread_title:  Infobox 

message: Several of the "footnotes" (often to a full paragraph) also appear in the references list. Can they be combined without losing the ability to support individual statements? Finavon 23:14, 9 October 2006 (UTC)
thread_title:  References & Notes 

message: Someone needs to edit this page so a laymen can understand it. I want to understand what shock is, medically, but it needs to be explained to me. There is too much assumed knowledge on this. It's an encyclopedia - anyone should be able to understand it. 
*Is it possible to elaborate on what part and which words you do not understand?Nomen NescioGnothi seauton 13:24, 13 August 2007 (UTC)
replies: text: I agree with whoever wrote the first point here. I was curious about what exactly it means when somebody goes into shock, and I just wanted a quick explanation. I came here and can't even read this, as I have no medical background, and I don't really care to first spend hours studying just to get a basic idea of it. I found this on the NIH website: "Shock is a life-threatening condition that occurs when the body is not getting enough blood flow. This can damage multiple organs. Shock requires IMMEDIATE medical treatment and can get worse very rapidly." That's all I wanted to know; is it possible to say something similar (without copying, of course) at the top of this page for us laymen, while leaving the rest intact, so we don't have to first learn what these all mean: adenosine triphosphate, hypoxia, pyruvic acid, metabolic acidosis, baroreceptors, noradrenaline, Renin-angiotensin, arginine vasopressin, renal system, Renin-angiotensin axis, homeostatic, compensatory mechanisms, perfusion of the cells, anaerobic metabolism, arteriolar, precapillary sphincters, hydrostatic pressure, micro-circulation, reduced perfusion? Jeffcogs 01:16, 7 September 2007 (UTC)
replies: text: I have updated the introduction here (although not got in to the body of the text as yet).  You were all quite correct, I imagine it was quite difficult for a lay reader.  Have a look at the new intro, and see if you think its pitched at the right level. Owain.davies 07:54, 9 September 2007 (UTC)
replies: text: For me, this new intro is much better, providing a good intro for those of us who aren't medical people. Thanks! Jeffcogs 14:40, 14 September 2007 (UTC)
thread_title: Unclear

message: :GA review (see here for criteria)
#It is reasonably well written.
#:a (prose):A bit wordy and over-complicated. Try to use simple sentences in the active voice. Just some examples from the first section:
#::"The process of removing these compounds from the cells by the liver requires oxygen, which is absent." would be better as "These compounds are normally removed from the cells by the liver, but this requires oxygen so the liver cannot do this during hypoxia."
#::"This stage is characterised by the body employing physiological mechanisms, including neural, hormonal and bio-chemical mechanisms in an attempt to reverse the condition." would be better as "During this stage the body employs physiological mechanisms, including neural, hormonal and biochemical changes in attempts 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." would be better as "Acidosis causes the person to hyperventilate, which removes carbon dioxide (CO2) from their blood. As this gas acidifies the blood by producing carbonic acid, hyperventilation is an attempt by the body to raise the pH of the blood back to the normal value."
#::Introduction to the section on "Stages of shock" needs to list the stages and give a brief overview, so the reader isn't plunged into the details if they are skimming the article.
#:b (MoS): 
#::No sections on Diagnosis, Prevention or History (see MedMOS). I realise that there are a very broad set of causes, so for prevention it would probably be OK to just state at the start of the section on types of shock that prevention depends on treating the particular cause of the condition (unless there are general preventative measures). The section on "Signs and symptoms" could be renamed "Symptoms and diagnosis".
#It is factually accurate and verifiable.
#:a (statements):
#::The discussion of cellular pathology in "Stages of shock - Initial" is a bit confused. Is it the lack of oxygen that causes disruption of the plasma membrane, or the lack of ATP? Simlarly, it isn't the fact that cells become more permeable that causes them to switch to anaerobic respiration, it is the lack of oxygen. Causes and effects are a bit confused in this section.
#::The liver doesn't remove compounds from cells, it removes them from the circulation.
#::"Renin-angiotensin axis is activated" - What is the "axis"?
#::"a fifth form of shock has been introduced" - might be better to say a "fifth classification", so it doesn't sound like doctors are promoting a new form of illness! :)
#:b (citations to reliable sources):
#::Many sections have no citations. A reader should be able to check where a statement comes from, and the citations in the text lack page numbers.
#:c (OR):
#::No obvious OR I can spot, but few citations so it takes specialised knowledge to say this.
#It is broad in its coverage.
#:a (major aspects):
#::Yes, although a history section would be a good addition.
#:b (focused):
#::Yes, good.
#4. It follows the neutral point of view policy.
#:Fair representation without bias:
#::Fine.
#5. It is stable.
#:No edit wars etc.:
#::None.
#6. It is illustrated by images, where possible and appropriate.
#:a (images are tagged and non-free images have fair use rationales): 
#:b (appropriate use with suitable captions):
#::The shock therapy image would be much better as a table or list, there is no need for a figure only containing text.
#7. Overall:
#::Fail I'm afraid. It's got all the information for a GA, but particularly with the citation problems and the rather dense prose I can't pass this at the moment. Tim Vickers (talk) 16:49, 6 April 2008 (UTC)
thread_title: GA review

message: HI i would like to know if there is loss of consciousness during shockEl thunder (talk) 12:03, 24 June 2008 (UTC)
replies: text: All forms of shock will lead to reduced and then loss of conciousness in latter stages. OwainDavies (about)(talk) edited at 19:44, 24 June 2008 (UTC)
thread_title:  loss of consciousness 

message: Having just completed a class on basic first aid, I'm aware that while waiting for EMS to arrive, it's recommended that a shock victim's legs be elevated 12-18 inches (victim is lying on back). Should this information be added to the Treatment section? --Spiff666 (talk) 18:59, 5 November 2010 (UTC)
replies: text: This is a strange bit of logic about the "debate" between stay and stabilize or load and go: "respecting the golden hour. If surgery is required, it should be performed within the first hour to maximise the patient's chance of survival."  If one actually reads the article on the Golden Hour, it emphasizes doubt on the validity of the entire concept. I suspect the writer didn't actually read the Wikipedia Golden hour (medicine) article, and has not kept up-to-date in the field either. Without references or citations, it sounds like a "debate around the water cooler" rather than policy debate. I vote for deletion. Cuvtixo (talk) 01:41, 21 October 2008 (UTC)

text: Based on the lack of real supporting evidence, or dissent from other users, I will edit the article accordingly. Nickers (talk) 18:56, 28 October 2008 (UTC)
thread_title:  Treatment  Section 

message: Not an accepted form of shock.  Hyperthyroid is cardiogenic as it works via cardiomyopathy and Addisonian crisis as a type of distribution shock.--Doc James (talk · contribs · email) 21:24, 18 April 2009 (UTC)
replies: text: I have a copy of Irwin and it does not once comment on endocrine shock.  Thus we have a serious problems.  Please add page numbers for this ref.  Uptodate does not recognize this either.  Looks like OR?--Doc James (talk · contribs · email) 21:32, 18 April 2009 (UTC)
thread_title:  Endocrine 

message: I've added William R. Emerson, that is one of his works. Here it is listed .
:Austerlitz -- 88.75.203.240 (talk) 08:38, 16 July 2009 (UTC)
thread_title:  References 

message: This article was basically illegible to two reasonably non-simian laypeople. It piles on terminology from the first paragraph.
How about opening with a straightforward definition aimed at someone without a medical degree?  —Preceding unsigned comment added by 98.108.26.187 (talk) 00:29, 27 June 2010 (UTC)
thread_title:  Woosh. 

message: I know I'm merely a humble EMT, but I've never heard the association of the Cushing's reflex/ Cushing's triad with anything other than increased intracranial pressure--and certainly not with shock. Moreover, the article currently is phrased so that it sounds as if the adrenaline response 
(and subsequent increase in blood pressure and heart rate) are the Cushing's reflex/triad while the true Cushing's triad is, in fact, traditionally marked by bradycardia (although, admittedly also by increased systolic pressure). Can anyone validate this? Is there even any reason for mention of the Cushing's reflex in relation to shock?
-3loodlust (talk) 01:28, 15 November 2010 (UTC)
thread_title:  Cushing's? 

message: I embedded definitions of the relevant medical terms early in the article.  I think the very first sentence of the article should be simple enough to effectively define shock without using a word (perfusion) unknown to a layperson.
Did the same with rapid heartbeat/low blood pressure.  No need for non-specialist readers to have to click on an entire new article to get a meaning that can be communicated in two words.  — Preceding unsigned comment added by 67.169.117.19 (talk) 03:32, 28 May 2011 (UTC)
thread_title:  Simplification for non-specialists 

message: This is not a B article, I am down-grading it.  There are too many uncited statements, poor reference style in some of the cited statements.  There are too many lists which can be converted to prose or tables.  Just too many problems in general. Bloomingdedalus (talk) 22:46, 22 June 2011 (UTC)
thread_title:  Not a B 

message: *Doc James (talk · contribs · email) 14:18, 30 August 2011 (UTC)
thread_title: References

message: The edits of the past days, transforming the subtypes as discussed in numerous textbooks, into some sort of DD is a mystery to me. The most relevant sources have been eliminated (Rippe, FCCS), from what used to be the best part of this article, which has proven that improvement was not the principal goal. Was there a compelling reason to rewrite that paragraph to no longer reflect the sources? Or, was the fact the sources were not part of the decision the cause of removing them alltogether?--- Nomen Nescio Gnothi seautoncontributions 14:36, 22 September 2011 (UTC)
replies: text: The source Rippe is from 2003. Updating per WP:MEDRS. Another reason for the rewrite is we are trying to write in an encyclopedic format (which means in prose rather than in lists). The Rippe text looks good just should use a newer version. BTW references to it have not been removed by me (except the one in the lead)... Doc James (talk · contribs · email) 02:20, 9 October 2011 (UTC)
thread_title: Recent edit

message: Should we include a link to this article somewhere? Apparently it has a significant role to play in shock. http://en.wikipedia.org/wiki/Myocardial_depressant_factor
Td1wk (talk) 21:32, 3 May 2012 (UTC)
thread_title:  MDF 

message: Please could we have a totally simple section in the article on First Aid applications, basically: (1) what causes it, (2) how to recognise the condition, (3) how to give basic treatment while waiting for a doctor or ambulance ?  Thanks. Darkman101 (talk) 20:59, 19 August 2012 (UTC)
replies: text: That sounds like it would be WP:HOWTO, which isn't permitted.  That is in the Wikibook on First Aid. OwainDavies (about)(talk) edited at 12:23, 20 August 2012 (UTC)
thread_title:  First Aid - The Basics for Ordinary People 

message: The Fluids section says that "Aggressive intravenous fluids are recommended". A BBC News online story today claims that Child shock guidelines 'are deadly', citing a study in N Engl J Med 2011. The study found that bolus-fluid increased the risk of death, and "could not find any subgroup in which fluid resuscitation was beneficial". Should this be mentioned in the fluids section? I don't have the expertise. - Pointillist (talk) 08:56, 14 January 2014 (UTC)
thread_title:  Fluids in child shock questioned 

message: Nice elucidation of the the positive feedback effect of circulatory shock. Consider adding briefly to the lead physical signs and symptoms (i.e.  cool and clammy skin), the stages of shock from pre-shock to end organ failure, and the 3 (or 4) types of shock.  — Preceding unsigned comment added by Dfhicks12 (talk • contribs) 00:16, 25 February 2015 (UTC)
thread_title:  Suggestions for Improvement 

message: doi:10.1056/NEJMra1705649 JFW | T@lk 09:31, 26 January 2018 (UTC)
thread_title:  [[Hemorrhagic shock]] NEJM 

message: All forms of shock have a group of basic symptoms. In my opinion those should be discussed under the main "signs and symptoms" heading with subsequent sections only discussing the symptoms specific or special to that form. Doc James (talk · contribs · email) 08:07, 16 November 2019 (UTC)
replies: text: Agree. JFW | T@lk 21:18, 16 November 2019 (UTC)
thread_title: Symptoms

message: Hypoperfusion is currently redirected to shock. However, I personally think ischemia is a better place for the redirection of hypoperfusion. How do you people think? --Envisaging tier (talk) 05:31, 24 December 2019 (UTC)
replies: text: None of those terms are completely identical. Hypoperfusion doesn't always mean shock but it also doesn't mean ischaemia in the strictest sense... JFW | T@lk 13:05, 26 December 2019 (UTC)
replies: text:  Thank you for the reply. Some Wikipedians also discussed the matter at Talk:hypoperfusion. You're very welcomed to join! --Envisaging tier (talk) 16:00, 26 December 2019 (UTC)
thread_title:  Redirection for hypoperfusion 

message: An editor has identified a potential problem with the redirect :Shock(circulatory) and has thus listed it for discussion. This discussion will occur at Wikipedia:Redirects for discussion/Log/2022 April 22#Shock(circulatory) until a consensus is reached, and readers of this page are welcome to contribute to the discussion.  Steel1943 (talk) 06:01, 22 April 2022 (UTC)
thread_title:  "Shock(circulatory)" listed at [[Wikipedia:Redirects for discussion|Redirects for discussion]] 

message: I suggest renaming the article from Shock (circulatory) to Circulatory shock.
Per WP:TITLEDAB, natural disambiguation is preferred over parenthetical disambiguation. The full phrase “circulatory shock” seems to be common enough to be a good title for this article. 2600:8802:6900:62:0:0:0:1008 (talk) 03:19, 2 July 2022 (UTC)
thread_title:  Rename with natural title