Neurogenic Shock

After working through this material, the Canadian RN will be able to: - Explain how a high spinal cord lesion removes sympathetic tone and leaves vagal tone unopposed. - Recognize the pattern of hypotension, bradycardia and peripheral vasodilation, and separate it from hemorrhagic shock, spinal shock and autonomic dysreflexia. - Apply the trauma rule that bleeding must be searched for in every hypotensive patient, even when the heart rate is slow. - State the current blood pressure targets for acute spinal cord injury, who set them, and how strong the evidence is. - Prepare for and monitor fluids, vasopressors, atropine and pacing under an order or protocol. - Protect the spine, airway, temperature, skin, bladder and veins while the patient is in the acute phase. - Escalate deterioration and teach patients and families what to expect.