"Stay with me!"

a factor that seems relevant to the discussion, and might throw some light, is that you can actually consciously have a strong effect on your blood pressure.

for instance, just thinking distressing things, or thinking about embarrasing moments can lead to a rise in BP and also heighten your Heart Frequency... So I don't think is too far-fetched to say, that struggling to keep consciousness can have an important effect in maintaining BP which is actually pretty much the most important thing to not enter in shock state
 
Ririon said:
It would explain why it is like that on average, which is the result (if not the point made based on those that result).

The data does not imply mechanisms. People who interpret data do. Me, I'm "just sayin'". :)

Yes, it would be problematic in several ways. I don't really have a good solution here. It is more speculation than anything else on my part. But given the lack of "gold standard" data, there is room for speculation.
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I'm not certain which studies LL was referring to, but my understanding is that in some studies, a group of people, all of whom had similar heart diseases, were monitored, and it turned out that on average, the depressed ones tended not to live as long. Things such as the severity of the disease and additional medical conditions would have been controlled for, and have been insufficient to explain the correlation between depression and life expectancy.

So it's not just a matter of heart patients being depressed; the point is that the heart patients that get depressed die earlier. As they have no way of knowing beforehand they'll be dying earlier than the others, it doesn't make sense to assume they are more depressed because they will.
 
Mirrorglass said:
I'm not certain which studies LL was referring to, but my understanding is that in some studies, a group of people, all of whom had similar heart diseases, were monitored, and it turned out that on average, the depressed ones tended not to live as long. Things such as the severity of the disease and additional medical conditions would have been controlled for, and have been insufficient to explain the correlation between depression and life expectancy.
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All well and good.
So it's not just a matter of heart patients being depressed; the point is that the heart patients that get depressed die earlier. As they have no way of knowing beforehand they'll be dying earlier than the others, it doesn't make sense to assume they are more depressed because they will.
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It makes sense to me. :) Maybe my logic is a bit off today.

I'll try to word it differently: Maybe some of them have irrational and instinctive feelings that tell them that they will live longer. That will show up in this sort of study only as less depression. But just because a feeling is irrational and instinctive does not mean it is wrong or baseless. It could very likely be slightly right on average. So if their instinctive guesses that they will do fine will lead to less depression. And their basis for this guess (their informal knowledge through experience of how their own bodies responds to illness better than others) may lead to them living longer. Presto: Correlation.
 
My understand is that "shock" is a survival mechanism. It would seem to follow that forcing people to stay conscious would be counterproductive -- unless ther were some other reason like potential hypothermia.
 
Ririon said:
All well and good.

It makes sense to me. :) Maybe my logic is a bit off today.

I'll try to word it differently: Maybe some of them have irrational and instinctive feelings that tell them that they will live longer. That will show up in this sort of study only as less depression. But just because a feeling is irrational and instinctive does not mean it is wrong or baseless. It could very likely be slightly right on average. So if their instinctive guesses that they will do fine will lead to less depression. And their basis for this guess (their informal knowledge through experience of how their own bodies responds to illness better than others) may lead to them living longer. Presto: Correlation.
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Yes, I do see that. But that brings us to my original point; if one hypothesis requires invoking a form of precognition which is not supported or suggested by any existing studies, the other one is far more likely.

It's true that such a thing could confound the results. But I don't think there's any reason to assume it actually exists.
 
Mirrorglass said:
Yes, I do see that. But that brings us to my original point; if one hypothesis requires invoking a form of precognition which is not supported or suggested by any existing studies, the other one is far more likely.

It's true that such a thing could confound the results. But I don't think there's any reason to assume it actually exists.
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Well, it's not precognition. It is more an estimate of what will happen in the future. I feel like I will live for another 40-ish years. I COULD drop dead tomorrow or live to be over 100, so I am not predicting the future. But on average I am not far off.

This hypothesis would be supported by the numbers here, and is suggested by me. So it is supported and suggested just fine.

It could still be wrong, though. Maybe people who think they will die soon are NOT more depressed than people who think they will live longer. I don't have anything but my gut feeling to back that up with. :) (This got a bit morbid, but OK.)
 
There has been a lot of work done on whether a "positive mental attitude" can help people survive serious illness, such as cancer. While the general attitude in the popular press is that "being positve" and "not giving up" are very important, this actually not what the studies suggest; there is a good (fulltext) review here.

In the acute situation, people who are in "shock" have by definition impaired blood flow to vital organs. This often includes the brain, and can manifest as anything from mild confusion to actual coma; its difficult to envisage how a positive mental attitude could have an efect in these situations.
 
Criticalist said:
There has been a lot of work done on whether a "positive mental attitude" can help people survive serious illness, such as cancer. While the general attitude in the popular press is that "being positve" and "not giving up" are very important, this actually not what the studies suggest; there is a good (fulltext) review here.

In the acute situation, people who are in "shock" have by definition impaired blood flow to vital organs. This often includes the brain, and can manifest as anything from mild confusion to actual coma; its difficult to envisage how a positive mental attitude could have an efect in these situations.
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So in the acute situation, under what conditions would the patient actually benefit from some shouting and/or face slapping (possible adrenalin boost)? Alcohol poisoning? Concussion? Blood loss? Drug overdose? Sleeping pill suicide attempt? Demonic possession?
 
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Ririon said:
Well, it's not precognition. It is more an estimate of what will happen in the future. I feel like I will live for another 40-ish years. I COULD drop dead tomorrow or live to be over 100, so I am not predicting the future. But on average I am not far off.

This hypothesis would be supported by the numbers here, and is suggested by me. So it is supported and suggested just fine.

It could still be wrong, though. Maybe people who think they will die soon are NOT more depressed than people who think they will live longer. I don't have anything but my gut feeling to back that up with. :) (This got a bit morbid, but OK.)
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Ah, so you are saying that on average, people predict the times of their own deaths fairly accurately? That's an interesting claim, and one I haven't heard before. Do you have some data you're basing this on?
 
Perpetual Student said:
My understand is that "shock" is a survival mechanism. It would seem to follow that forcing people to stay conscious would be counterproductive -- unless ther were some other reason like potential hypothermia.
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I don't think that is correct. Anaphylaxis is not a survival mechanism and neither is shock. I can't think of any benefit in having your cardiovascular system collapse.
 
Criticalist said:
...
In the acute situation, people who are in "shock" have by definition impaired blood flow to vital organs. This often includes the brain, and can manifest as anything from mild confusion to actual coma; its difficult to envisage how a positive mental attitude could have an efect in these situations.
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I thought that comment was saying remaining conscious might also contribute to increased blood pressure in a case of shock. It makes sense.
 
Ririon said:
So in the acute situation, under what conditions would the patient actually benefit from some shouting and/or face slapping (possible adrenalin boost)? Alcohol poisoning? Concussion? Blood loss? Drug overdose? Sleeping pill suicide attempt? Demonic possession?
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Definitely with any kind of over sedation outside of the hospital you would want to keep a person awake. But you don't need to slap anyone.

Concussion, the only reason to wake someone is to judge if their mental status is deteriorating.

With shock, you need to conserve their energy and get the blood to vital organs.

Demons, wake them if it is a nightmare, and don't stimulate them if it is mental illness. ;)
 
Mirrorglass said:
Ah, so you are saying that on average, people predict the times of their own deaths fairly accurately? That's an interesting claim, and one I haven't heard before. Do you have some data you're basing this on?
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If I recall, there is some evidence people die more often after hanging on until a birthday or some other event. But I don't know if a study I read decades ago would hold up under more critical analysis of research methods we have today.
 
Skeptic Ginger said:
If I recall, there is some evidence people die more often after hanging on until a birthday or some other event. But I don't know if a study I read decades ago would hold up under more critical analysis of research methods we have today.
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Yes, studies like this do tend to be notoriously unreliable. There are vast amounts of confounding factors.

I suppose it's also not a particularly useful avenue of study, from a clinical perspective, so I doubt there are that many studies, anyway.
 
I always thought the issue was that when a person loses consciousness, the autonomic nervous system slows down. Blood pressure goes down, pules rate and breathing slows. If the person is already on the edge due to injury, this could cause these processes to drop below a critical point that could lead to death.

At least, that's always been my assumption.
 
Also, there are some brain injuries that cause a person to only be able to breathe voluntarily. As soon as they lose consciousness, they stop breathing and die.

I would think this is pretty rare, though.
 
aggle-rithm said:
I always thought the issue was that when a person loses consciousness, the autonomic nervous system slows down. Blood pressure goes down, pules rate and breathing slows. If the person is already on the edge due to injury, this could cause these processes to drop below a critical point that could lead to death.

At least, that's always been my assumption.
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Thats not really correct. Loss of consciousness is part of the spectrum of injury, not a response or adaptation to it. As you lose consciousness you are at greater risk of death or severe injury, mostly due to the possibility of airway obstruction. The muscles and tissuues in the upper airway become relaxed and this can cause both gastric contents to regurgitate into the lungs, or the airway itself to be blocked which will rapidly lead to cardiac arrest and death.

The algorithm to approaching any seriously ill patient is always the same; "ABC" - Airway, Breathing, Circulation. Assessing and maintaining a clear airway is always the number one priority in resuscitation.
 
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