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Neurogenic Shock

 

Neurogenic shock results from trauma to the spinal cord.
Muscle flaccidity and loss of reflexes below the injury (spinal shock) is followed by mild hypotension and bradycardia (neurogenic shock) from damage to descending sympathetic pathways in the cord.

Treatment consists of :

1. The ABCs of resuscitation;
2. Proper spinal immobilization;
3. Intravenous normal saline to maintain a systolic pressure above 70 mmHg;
4. If unable to maintain the blood pressure, dopamine 5 ug/kg/min is added;
5. Bradycardia may be treated with atropine 1 mg IV every 5 minutes to a total dose of 3 mg or a pacemaker if needed;
6. Methylprednisolone 30 mg/kg over 15 min is administered, followed by an infusion of 5.4 mg/kg per hour (controversial) and
7. The patient is transferred to an appropriate spinal-cord facility.

 


 
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