Truth really can be stranger than fiction.
First Page - Now launched! All the stories are true, or based on real events. Unlimited reading for $10.00 / month. No downloads. Read on your phone, tablet or computer.
La verdad puede ser más extraña que la ficción.
First Page - ¡Ya está en marcha! Todas las historias son verídicas, o están basadas en hechos reales. Lectura ilimitada por $4.99 / mes. No hay que descargar nada. Lea en su teléfono, tableta u ordenador.
The Beauty of Staying Together (Former Title: DETOUR
Calvina, the young battered wife of Duane, is in desperate need of a new start in life. Will her jealous husband, the mad man with whom she had been unequally yoked, prove too much to ever hope for a chance of staying together--a chance to fix her troubled marriage?
We encourage you to read the two main character profiles before reading the first chapter. We can be so wrong in the strong initial opinions we form of people, which we see in The Beauty Of Staying Together (originally published under the title: Detour), a story based on true events.
¿Qué tiene que ver conmigo? por Teófila Gottfried
Lo que leemos en la Biblia tiene que ver con todos los seres humanos, sean cristianos o judíos, ateos o agnósticos, budistas, musulmanes o adherentes a alguna de las filosofías o nuevas religiones que surgen en el mundo. ¿Por qué? Ver mayor información sobre este interesante libro.
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Manna Minutes Podcast: Eye-opening Bible study in less than five minutes! Access all episodes here.
Manna Minutes en español:
Estudio bíblico que nos hace abrir los ojos en menos de cinco minutos! Acceda a todos los episodios aquí.
Manna Minutes Podcast auf Deutsch:
Augenöffnendes Bibelstudium in weniger als fünf Minuten! Alle Episoden finden Sie hier.
What Are the Different Types of Shock?
What Is Shock?
Perfusion is a term used among health care providers indicating supply of oxygen to the cells of the body and removal of wastes from those cells resulting from blood flow through capillaries. Capillaries are the smallest of blood vessels. Hypoperfusion is inadequate perfusion, commonly known as shock. Few laypeople are aware of the fact that there are different types of shock.
Simple Definitions for Different Types of Shock
Hypovolemic, cardiogenic, and neurogenic shock are the three major types of shock. Hypvolemic shock is hypoperfusion resulting from a loss of blood or fluid. When it sets in as a result of a loss of blood, it is often referred to as hemorrhagic shock. Hemorrhage means bleeding, particularly uncontrolled bleeding. Remember that bleeding can be internal, external, or a combination of both. Therefore, a person can suffer hemorrhagic shock in the absence of visible external bleeding. Victims of burns lose some plasma (the fluid portion of blood). Again, when hypoperfusion is caused by blood OR fluid loss, it is hypovolemic shock, the most commonly seen type of shock by emergency medical technicians (EMTs).
Cardiogenic shock does not result from a loss of blood or plasma. However, it is still considered a life-threatening condition. When the pumping action of the heart becomes inadequate, cells of the body can suffer "starvation" of oxygen and contamination due to the retention of waste products. This type of shock can result from a myocardial infarction (heart attack) or congestive heart failure (CHF).
Nerve paralysis can give rise to neurogenic shock, which is hypoperfusion caused by dilated blood vessels. Wider (dilated) blood vessels might not be able to be filled with blood, resulting in inadequate flow of blood to the cells of the body. It can occur after an injury to the spinal cord.
Signs and Symptoms of Different Types of Shock
Whether the cause of shock is hypovolemic, cardiogenic, or neurogenic, most of the signs and symptoms for one type are identical to another type. One of the most important things to remember about these different types of shock is that there are early signs and symptoms and there are late signs and symptoms. If you know the early signs and symptoms, the victim might have a better chance of survival because of early detection and early intervention.
Below is a list of the signs and symptoms of the different types of shock in the order in which they almost always appear.
1. Altered mental status - The brain is one of the most sensitive organs to insufficient oxygen. Consequently, even slight alterations in mental status can be an indication of possible shock. The person might become very anxious or even combative.
2. Pale, cool, clammy skin - The body is the "first responder" to its medical emergencies. One of the ways it attempts to help itself when facing shock is to divert life-giving blood away from the skin toward vital organs. As blood is diverted away from the skin for the sake of organs such as the heart and brain, temperature decreases and skin color "fades." Note that this particular sign is not typically seen in neurogenic shock.
3. Organs such as the heart and brain are more important than those of the digestive system. Therefore, the body, in an attempt to save itself can divert blood away from the digestive system in favor of more vital organs, resulting in nausea and vomiting. If someone in shock says that he is thirsty, this is not a good sign.
4. Changes in vital signs - The first of the vital signs to change are respiratory and pulse rates. The pulse increases--evidence that the heart is trying to protect itself and the rest of the body by pumping faster. However, as it keeps this up, the pulse eventually becomes weak as the amount of blood it is pumping decreases. Breathing also increases in a desperate attempt to take in more oxygen to be delivered to cells to keep them alive. Eventually, respirations can become shallow and labored.
5. Drop in blood pressure - This is a very late sign indicating that the person is very close to slipping away.
Other signs and symptoms of the different types of shock are pupils that are dilated and cyanosis (bluish color) around the lips and the beds of the nails.
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