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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)
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
