Neurogenic shock

• Usually above T6 injury - high level
  • Disruption of SNS communication from T1 → L2
• Loss of catecholamines (A, NA) which normally maintain vascular tone and keep HR up so the net effect is
  • Hypotension (vasodilatation)
  • Bradycardia (loss of NA/A)
• Management
  • ABCDE and cervical spine measures
  • Maintain BP
  • Bradycardia - Atropine
  • Hypotension and vasopressors - IVF - target MAP >80

Spinal shock

• Just spinal cord affected
  • Anywhere along spinal cord
• Local bleeding and tissue damage
  • Release chemical mediators
  • Cause potent vasoconstriction
    • = spinal cord ischaemia and hypoxia
  • Net effect = paralysis contralateral pain and temp, ipsilateral motor and vibriation/proprioception
    • Loss of sensation below the level of the injury
    • Dependent on injury
    • Partial vs complete
    • May regain sensation dependent on injury (not if complete)
    • If compression
      • When inflammation and pressure relieved
      • Patient regains sensation, feeling, movement below the level