Neurogenic Shock

Question 1

Neurogenic Shock
Adult Management

Answer 1

▪ Rapid transport, keep on-scene times less than 10 minutes.
▪ Maintain an SpO2 of 95% and EtCO2 levels between 35-45 mmHg.
▪ Cervical Spinal Motion Restriction if indicated.
▪ Maintain body temperature with blankets and consider increasing the temperature in the patient compartment.

Question 2

Neurogenic Shock
Fluid Resuscitation

Answer 2

▪ Establish two large bore IVs while enroute. NEVER delay transport to start IVs on scene.
▪ Internal hemorrhage
▪ Give enough normal saline up to 1L to maintain a blood pressure high enough for adequate peripheral perfusion (radial pulse). The presence of a radial pulse equates to a SBP of 90 mmHg, which is the goal of fluid resuscitation for a patient with suspected internal hemorrhage.
▪ Bolus of Normal Saline 500mL, reassess blood pressure and lung sounds prior to each bolus. Maximum 1L.-
▪ Push Dose Epinephrine: If patient remains hypotensive despite IVF