Difference between revisions of "Neurogenic shock"

(See Also)
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#Atropine if needed
 
#Atropine if needed
 
#Keep warm
 
#Keep warm
 
==Prognosis==
 
*If cord is contused, not transected, prognosis is good
 
**Bulbocavernosus reflex should return w/in 24-48 hr
 
  
 
==Source ==
 
==Source ==
*Tintinalli's
+
*Tintinalli
  
 
==See Also==
 
==See Also==

Revision as of 23:52, 2 March 2012

Background

  • Do not confuse with Spinal Shock
  • 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

  1. Exclude other causes of shock
  2. IVF (MAP goal >90)
  3. Pressors if needed
  4. Atropine if needed
  5. Keep warm

Source

  • Tintinalli

See Also