Difference between revisions of "Neurogenic shock"
m (Rossdonaldson1 moved page Neurogenic Shock to Neurogenic shock) |
|||
| Line 14: | Line 14: | ||
*Peripherally vasodilated (warm extremities) | *Peripherally vasodilated (warm extremities) | ||
**May lead to hypothermia | **May lead to hypothermia | ||
| + | |||
| + | ==Differential Diagnosis== | ||
| + | {{Shock DDX}} | ||
==Treatment== | ==Treatment== | ||
Revision as of 07:50, 18 February 2015
Contents
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 sympathetic denervation
- T1-L3: Partial sympathetic denervation
- Below L4: no sympathetic denervation
- Lasts 1-3 wk
Diagnosis
- Hypotension (well tolerated)
- Bradycardia
- Peripherally vasodilated (warm extremities)
- May lead to hypothermia
Differential Diagnosis
Shock
- Cardiogenic
- Acute valvular Regurgitation/VSD
- CHF
- Dysrhythmia
- ACS
- Myocardial Contusion
- Myocarditis
- Drug toxicity (e.g. beta blocker, CCB, or bupropion OD)
- Obstructive
- Distributive
- Hypovolemic
- Severe dehydration
- Hemorrhagic shock (traumatic and non-traumatic)
Treatment
- Exclude other causes of shock
- IVF (MAP goal >90)
- Pressors if needed
- Atropine if needed
- Keep warm
Source
- Tintinalli
See Also
Authors:
Daniel Eggeman, Jordan Swartz, Kevin Lu, Neil Young, Daniel Ostermayer, robot, Ross Donaldson