The conceptual differentiation of spinal and neurogenic shock tends to be misunderstood among clinicians. In order to better illustrate the differences in definition, presentation, and development of spinal shock (SS) from neurogenic and other forms of shock, we present herein a clinically relevant summary of typical characteristics of SS. First described in the eighteenth century, the continued investigation into the disease process and the response of neural structures to spinal cord trauma have led to a more complete description and understanding. We will begin in the first part of the chapter describing the etiology of SS, including a working definition, as it pertains to complete spinal cord injuries (SCIs). This is followed by the summary of pathophysiology and clinical presentations associated with each clinical phase of SS. Finally, we explore treatment options and considerations as they relate to incomplete SCI. We hope that by presenting a clear and well-delineated overview of SS, we will allow the clinician to better understand and more accurately predict the evolution of this process. This, in turn, should facilitate the ability to deliver better care for the patient.
Part of the book: Clinical Management of Shock
Human communication and interaction had been rapidly evolving with the advent and continuing influence of social media (SM) thereby accelerating information exchange and increasing global connectivity. Despite clear advantages, this new technology can present unintended consequences including medical misinformation and “fake news.” Although International Health Security (IHS) stands to benefit tremendously from various SM platforms, high-level decision-makers and other stakeholders must also be aware of the dangers related to its intentional and unintentional misuse (and abuse). An overview of SM utility in fighting disease, disseminating life-saving information, and organizing people and teams in a constructive fashion is discussed herein. The potential negatives associated with SM misuse, including intentional and unintentional misinformation, as well as the ability to organize people in a disruptive fashion, will also be presented. Our treatise will additionally outline how deliberate misinformation may lead to harmful behaviors, public health panics, and orchestrated patterns of distrust. In terms of both its affirmative and destructive considerations, SM can be viewed as an asymmetric influencing force, with observed effects (whether beneficial or harmful) being disproportionately greater than the cost of the intervention.