Neurogenic shock: Difference between revisions
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
*Do not confuse with [[Spinal Shock]] | |||
*Diagnosis of exclusion | *Diagnosis of exclusion | ||
**Never presume hypotension in trauma patient is due to neurogenic shock | **Never presume hypotension in trauma patient is due to neurogenic shock | ||
Revision as of 03:29, 17 July 2011
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
- 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