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    Walker Turambar's Avatar
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    Carol's Medicine

    Can any doctors or nurses answer this? Did that doctor say to give Carol epinephrine to lower her blood pressure? Does it do that or the opposite? I assumed it would raise it.

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    I'm not sure if he said "lower" or "raise" but epinephrine treats people with cardiac arrest. Works like adrenaline. Googled/Wikipedia'd it. It lowers blood pressure but it increases cerebral, and carotid circulation pressure.

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    I was Shocked that Beth went along with the medicine and trusted that DR...right after she just wanted to KILL him the last time we saw them...☺...

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    Quote Originally Posted by Lostie View Post
    I was Shocked that Beth went along with the medicine and trusted that DR...right after she just wanted to KILL him the last time we saw them...☺...
    Alas, nothing related to that hospital has made sense yet. It's the freaking Twilight Zone of the ZA. Up is down. Day is night.

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    I think he told her lowered, she'd be a fool to trust him completely and she isn't a fool but she isn't a doctor he is the only doctor desperate times.

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    Epinephrine IS adrenaline. In shock, it is used to increase blood pressure and, with it, end organ perfusion but is generally delivered as a carefully titrated continuous infusion, not a bolus dose (except acutely for anaphylaxis, arrhythmias, etc). In shock related specifically to trauma, it's not usually the right treatment regardless of how it's administered. Shock related to trauma is generally managed with surgical or procedural intervention +/- fluids/blood products. Neurogenic shock is an exception to that (except that fluid resuscitation is still mandatory) but is often managed with drugs other than epinephrine.

    I'd like to forget about the "medicine" in this episode now, please.

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    My roommate is in medical school and bitched about how it's supposed to raise your blood pressure, not lower it. She bitches about all of the medical shit that's been going on in this story.

    Since the show has been very inaccurate with this stuff in the past, I would say it's an inherent problem with having no medical consultants on the show, and not an intentional lie in the show.

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    Zombie Hoarder DarylsHand's Avatar
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    I think it has something to do with the shock to the system that happens being hit by a car, plus the mounting small injuries Carol was amassing. The body goes into shock and has to begin answering all of that pain and it just can't so it overloads. Epinephrine is what's in Epipens I believe? (can someone check that) -you basically stab those pens into the thigh muscle and the adrenaline allows your system to get a grip on all of those alarm bells. Epi is also used for anaphylaxis shock like if you are allergic to bees and get stung and begin swelling up.

    Adrenaline comes naturally from a lot of different things. Fight or flight mode increases it. Chewing can get it started. Skiing, skyjumping, van-dropping, running from zombies can all increase adrenaline. Carol was obviously at the end of her own ability to stave off shock. The pressure she handled extremely well. Getting hit by a car just gave her body way too much to handle.

    So then adrenaline would allow the body to handle all the requests it is getting to heal itself. Without adrenaline the body will just shut down and all those injuries have very little chance of being addressed. Blood pressure lowers, the mind sorts all of the mess out, then blood pressure returns to its best version of normal. The end result is raising blood pressure. Taking a step backwards to continue moving forward.

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    @ElJacko, the show either needs to hire a medical consultant or stop including anything remotely medical. Truly, the writers are starting to embarrass themselves. There is a lot of bad medicine on TV, but TWD appears to be competing to make its "medicine" the worst. Between this and the virus...

    @DustyHypothalamus, yes, epinephrine is what is found in EpiPens, which deliver epinephrine intramuscularly. I can't say that I've ever seen someone in shock and requiring epinephrine treatment as a result of his/her becoming epinephrine-depleted due to physical and emotional stress.

    Shock from "internal injuries" is generally the direct result of a specific injury or combination of injuries leading to blood loss, decreased heart filling with consequent loss of output (in major chest injuries), and/or neurological injury (brain/spinal cord). Obviously, that's not an exhaustive list, but it encompasses the majority of causes. As I said previously, the management of shock related to trauma is most commonly surgical/procedural and fluid/blood. There are few causes of shock related to trauma that would be managed with epinephrine and virtually none (except in the case of a life-threatening arrhythmia) that would be managed with bolus doses of epinephrine. A slow bolus dose is likely what Beth delivered unless she somehow, without a pump system, managed to instill the epinephrine in the IV tubing and optimize the IV drip rate such that she created a magically perfect epi infusion.

    Now, let's please all just accept that the "medicine" in this episode was a giant mess with no foundation in reality and forget its very existence.

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    Walker GenuineRisk's Avatar
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    Thanks guys. I'm not a medical professional, but it stuck out to me, as I thought it was used for allergic reactions, bad asthma attacks and in the case of cardiac arrest (that scene in Pulp Fiction- you know the one...). I couldn't see the use of it a day after an accident. Unless Dawn giving Beth the key to the drug cabinet pays off in the next episode, I'm not sure why that scene was in there at all. But then, scenes that don't pay off aren't exactly uncommon on the show, either. ;)

    It did make me think of an article on Cracked about how the show doesn't get right that people in health professions like pharmacists, dentists, etc., would be incredibly valuable in an apocalypse. I didn't buy the doctor freaking out about the injured oncologist in Beth's bottle episode. An oncologist is not a GP. And even if he was able to make a shift in the midst of society breaking down to general practice or internal medicine, they'd both be incredibly valuable. It's not an either-or.

    It is notable and lucky that none of the gang has had a cavity yet. Seriously, oral health. Very important. That can kill you.

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