Neurogenic shock implies that the body goes into shock due to a spinal injury which affects important

nerves that make up the autonomic nervous system (nervous system which is not in our control).

Injury to these nerves causes the walls of the blood vessels to relax resulting in slowing of the heart rate or bradycardia which can be fatal. Neurogenic shock is different from spinal shock; the latter means loss of function due to spinal injury which may be temporary or permanent. Causes of neurogenic shock 1. Trauma to the spinal cord which may be a penetrating or blunt injury. Injury to the spinal cord in the neck causes extremely severe symptoms while injury in the thoracic or lumbar spine causes less severe symptoms. 2. Regional anesthesia if improperly given can lead to neurogenic shock. 3. Drugs that affect the autonomic nervous system Symptoms and signs of neurogenic shock

The most important sign is slow heart rate (bradycardia) and low blood pressure (hypotension). The limbs are warm while the rest of the body is cold, the patient may feel very cold; this is called hypothermia

Cardiac output (the amount of the blood that the heart pumps with every contraction) is reduced. Neurological symptoms may be present, urine may cease

Pathophysiology Loss of sympathetic tone (parasympathetic response) results in massive vasodilitation, inhibition of the baro-receptor response, and impaired thermoregulation. Arterial vasodilitation = drop in BP Decrease in BP & drop in CO = impaired tissue perfusion. Inhibition of baro-receptors = no reflex tachycardia, further compromising tissue perfusion

Nursing Management Prevention by assessment of at risk patients Treat hypovolemia, maintain normothermia, prevent hypoxia, provide comfort and emotional support.

Medical and Surgical Management Large volumes of fluid may be needed to restore normal hemodynamics Vasopressors (Norepinephrine) Atropine (speeds up heart rate and Cardiac Output)

Far Eastern University Institute of Nursing

Neurogenic Shock
Submitted by: Glaizalyn F. Tagoon BSN406 Group 24B