# Is shock always the cause of death?



## LucidResq (Sep 28, 2008)

I've had this argument with numerous people. 

They state that every death is technically caused by shock. 

I say no. 

I use a combination of brain death and clinical death to define death. So absence of brain, heart and respiratory activity. 

What do you guys think?


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## EMT-P633 (Sep 28, 2008)

I would say hypoxia, 

But what is the deffintion of shock? inadequate tissue perfusion, right? 

Which would also cause the bodies cells to be hypoxic.


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## Hastings (Sep 29, 2008)

I've never heard anyone claim the cause of death was shock.

They usually default to cardiac arrest over here.



But to answer the question, no. Shock is such a broad term. There are many different types of shock. And that makes this a hard question. Shock is often the last stage before death, but it's not the cause. There are many underlying causes of shock. So I wouldn't say the cause of death is shock. I'd say the cause of death is whatever caused the shock. I mean, shock is still often a reversible condition. So, again, the cause would be whatever caused the shock. I...can't really wrap my head around this question.

I think you should blow the next person to debate it with you off, because I can't comprehend how one would argue for or against it.

Shock. Inadequate perfusion. Well. I mean, the heart would fail because of...inadequate perfusion, which is caused by a multitude of reasons. The brain would fail because of inadequate perfusion, caused by the same reasons. So I guess I can see it. If death is failure of the heart/brain, that would ultimately be caused by lack of perfusion, which is the result of a multitude of things. So yeah, I guess they are kinda right.


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## mycrofft (Sep 29, 2008)

*Used to say that, good trainer for beginners.*

Basis is that the other forms of COD (decapitation etc) cannot be addressed by first aid. They used to teach us about various "types" of shock, and this allowed them to include almost every type of COD by stretching it.

If brain death is the criterium, then whatever kills the brain kills "me". Hypoperfusion, direct trauma, hypoxia are the top three.


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## Ridryder911 (Sep 29, 2008)

Yes & No. Shock is cellular death, thus all things that would kill causes such. In reviewing almost all COD on the death certificate, number one cause of death is cardiac arrest. This being traumatic, long term, etc.. everyone dies of an cardiac arrest. 

R/r 911


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## BossyCow (Sep 29, 2008)

Cardiac arrest is a type of cardiogenic shock right?


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## BruceD (Oct 4, 2008)

Would 'shock' fit the definition?

*Cause of death* - the disease or injury that initiates a chain of events, brief or prolonged, which produces a fatal outcome

*Mechanism of death* - the final physiologic derangement, incompatible with continued life, produced by the cause of death, e.g. sepsis, respiratory depression, cardiac dysrhythmia, etc.

(ref: http://www.co.weld.co.us/departments/coroner/coroner_Terms.html )

Seems like 'shock' would be mechanism of death, while whatever produced the shock would be the cause...


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## MSDeltaFlt (Oct 4, 2008)

Q: What always causes death?

A: Breathing too much.  Everyone who has ever been considered ''alive'' has died.


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## ffemt8978 (Oct 4, 2008)

MSDeltaFlt said:


> Q: What always causes death?
> 
> A: Breathing too much.  Everyone who has ever been considered ''alive'' has died.



Birth is the first symptom of a terminal illness.


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## Sasha (Oct 4, 2008)

MSDeltaFlt said:


> Q: What always causes death?
> 
> A: Breathing too much.  Everyone who has ever been considered ''alive'' has died.



But not breathing is 100% fatal!


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## Stop_fighting_my_tube! (Jul 27, 2011)

*stop spreading foolishness*



Ridryder911 said:


> Yes & No. Shock is cellular death, thus all things that would kill causes such. In reviewing almost all COD on the death certificate, number one cause of death is cardiac arrest. This being traumatic, long term, etc.. everyone dies of an cardiac arrest.
> 
> R/r 911



False. Shock and cellular death can be related but are not equal. Shock is the sympyoms associated with inadequate perfusion, no matter what that looks like. Thus ischemic cardiac tgissue can lead gto cardiogenic shock, but the tissue can be reperfused and rehabilitated.  No one dies of sock....they die from exsanguinatgion, or anoxia, or asphyxiation---but no one dies from shock in the same way a pt witgh an allergic reaction isn't  going to die from hives.


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## Mr_Episiotomy (Jul 27, 2011)

*Shock*

Sit in an electric chair and see if the shock you receive does or does not cause death. There you'll find the answer


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## emt-mike (Jul 27, 2011)

^ oh YAY another new character in this troll game!


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## silver (Jul 27, 2011)

Stop_fighting_my_tube! said:


> False. Shock and cellular death can be related but are not equal. Shock is the sympyoms associated with inadequate perfusion, no matter what that looks like. Thus ischemic cardiac tgissue can lead gto cardiogenic shock, but the tissue can be reperfused and rehabilitated.  No one dies of sock....they die from exsanguinatgion, or anoxia, or asphyxiation---but no one dies from shock in the same way a pt witgh an allergic reaction isn't  going to die from hives.



So perfusion has to do with electrolytes and nutrients as well not just oxygen. People don't die from hypoglycemia, acidosis, and other electrolyte imbalances, because there is inadequate perfusion?


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## bigbaldguy (Jul 27, 2011)

Sorry got here as fast as I could "sprays anti troll spray around thread" I need to get a golf cart.

I was under the impression that death meant loss of perfusion long enough to cause cellular death and was caused by cardiac arrest, and shock was simply the symptoms caused by loss of perfusion which could include cellular death but didn't necessarily have to.


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## mycrofft (Jul 28, 2011)

*Better post: define shock.*

Too many "types" listed with disparate mechanisms.
Seems hard to call the fairly simple mechanism of "Cardiogenic _*shock*_" (due to asystole) when it has little or nothing to do with the cascading events of hypovolemic shock.


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## firetender (Jul 28, 2011)

*A non-flowery definition*

I understand shock as a system-complex that involves a progressive break down of function; a sort of Domino effect of one system faltering, leading to another slowing down, leading to another speeding up which further burdens another. Then, as it progresses, one by one they break down and stop functioning.

Many things can "trip" the beginning of that often relentless progression. It is not the causative factor of death, per se, but a major contributor to the end game.


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## Voodoo1 (Jul 28, 2011)

silver said:


> So perfusion has to do with electrolytes and nutrients as well not just oxygen.



Maybe we should carry IV bags full of gatorade. jk


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## Luno (Jul 28, 2011)

Hastings said:


> I think you should blow the next person to debate it with you off, because I can't comprehend how one would argue for or against it.



Uh, I'm here for the debate...


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## mgr22 (Jul 28, 2011)

I think some are confusing causes of shock with causes of death. Every death involves shock (inadequate tissue perfusion) but not every case of shock leads to death.


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## mycrofft (Jul 28, 2011)

*So shock means hypoperfusion.*

That leaves me wondering about insult (be it chemical or physical) directly attacking the brain.

 I think "shock" is a loosely defined  syndrome, and it has been lumped together as a means of teaching and research  rather than approached and named by its various varieties, as we have begun to with "cancer" and "diabetes".

Since it is perhaps the most common type which can be addresed by basic fisrt aid measures, then teaching it as the premier cause of death is OK, the same as teaching very little kids Columbus discovered America. If you go on into EMT and other necks of the woods, then we tell them the stork didn't bring you and Columbus was a relative latecomer (Norsemen in Newfoundland)to a land already populated.


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## akflightmedic (Jul 28, 2011)

I have always said it is Absolute Bradycardia which causes all deaths.


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## mycrofft (Jul 28, 2011)

*Mostly*

lub-dub--lub----dub---dub---wheeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeeee-----------------------------------------


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## MrBrown (Jul 28, 2011)

shock is in reality a group of aetiologies that share common a pathophysiologic cascade which if left untreated will cause death


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