Neurogenic shock: Difference between revisions
No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Diagnosis of exclusion | |||
**Never presume hypotension in trauma patient is due to neurogenic shock | |||
*Injury to cervical or thoracic vertebrae causes peripheral sympathetic denervation | |||
**Above T1: full | |||
**T1-L3: Partial | |||
**Below L4: none | |||
*Lasts 1-3 wk | |||
==Diagnosis== | ==Diagnosis== | ||
( | *Hypotension (well tolerated) | ||
*Bradycardia | |||
*Peripherally vasodilated (warm extremities) | |||
**May lead to hypothermia | |||
==Treatment== | ==Treatment== | ||
# | #Exclude other causes of shock | ||
# IVF ( | #IVF (MAP goal >90) | ||
# | #Pressors if needed | ||
# Atropine | #Atropine if needed | ||
# Keep warm | #Keep warm | ||
==Prognosis== | ==Prognosis== | ||
If cord is contused | *If cord is contused, not transected, prognosis is good | ||
**Bulbocavernosus reflex should return w/in 24-48 hr | |||
==Source == | ==Source == | ||
*Tintinalli's | |||
[[Category:Neuro]] | [[Category:Neuro]] | ||
[[Category:Trauma]] | [[Category:Trauma]] | ||
Revision as of 22:11, 12 July 2011
Background
- Diagnosis of exclusion
- Never presume hypotension in trauma patient is due to neurogenic shock
- Injury to cervical or thoracic vertebrae causes peripheral sympathetic denervation
- Above T1: full
- T1-L3: Partial
- Below L4: none
- Lasts 1-3 wk
Diagnosis
- Hypotension (well tolerated)
- Bradycardia
- Peripherally vasodilated (warm extremities)
- May lead to hypothermia
Treatment
- Exclude other causes of shock
- IVF (MAP goal >90)
- Pressors if needed
- Atropine if needed
- Keep warm
Prognosis
- If cord is contused, not transected, prognosis is good
- Bulbocavernosus reflex should return w/in 24-48 hr
Source
- Tintinalli's