1. Homepage
2. Why this site ?
3. References for this site
4. Stage 1: Pre-shock Anticipation
5. Stage 2: Pre-shock Slide
6. Stage 3: Compensated shock
7. Stage 4: Decompensated shock, but reversible
8. Stage 5: Decompensated shock, but irreversible
9. M.O.D.S / M.O.F.S
10. Vicious cycles
11. S.I.R.S.
12. Shock Combo
13. Microvascular Complications
14. Geneva Handshake
15. Other topics
16. contact

When you shake somebody's hand, you are getting in contact with the person's soul ... but you are also in close contact with two "great operators": (1) the autonomous nervous system (sympathetic and parasympathetic nervous systems) and (2) the inflammatory system. This handshake can be very useful in critically sick patients - a handshake I named the Geneva Handshake, (where this giraffe got its bedside manners...). But this is a dangerous maneuver: touching patients after patients, without hand washing, causes most hospital nosocomial infections because of cross-transmission with transient flora. Therefore the Geneva Handshake should be followed by hand "degerming", after each patient encounter (see: ref for Hand Hygiene Practice).


When two captains (sympathetic and inflammatory systems) are trying to work things out at the same time (especially in those very sick patients),...everything could go to hell in a hand basket. These 2 great operators are WAY TOO ACTIVATED in stages 4 and 5. They no longer collaborate. They are in it for survival of the whole system. They "talk" so loud now that they often overdo it and speed up the downward spiral (vicious cycles).