Neurogenic shock following high thoracic or cervical spinal cord injury is distinguished from haemorrhagic shock by:

• A Hypotension with compensatory tachycardia and cold peripheries
• B Hypotension with bradycardia and warm, well-perfused extremities ✓
• C Hypotension with oliguria and metabolic acidosis
• D Hypotension with narrow pulse pressure and thready pulse

Explanation

Neurogenic shock results from loss of sympathetic outflow (T1–L2) following high spinal cord injury, causing loss of vascular tone and cardiac acceleration. The hallmark triad is: hypotension (vasodilation), bradycardia (unopposed vagal tone without sympathetic compensation), and warm/dry/pink skin (peripheral vasodilation with good perfusion). This distinguishes it from haemorrhagic shock (hypotension + tachycardia + cold, clammy extremities). Management includes IV fluids cautiously and atropine/vasopressors (e.g., norepinephrine) rather than excessive fluid resuscitation.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

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Written and medically reviewed by the StethoPrep medical team.