A 28-year-old man sustains a C6 spinal cord injury after a diving accident. On arrival he is hypotensive with a blood pressure of 85/50 mmHg, heart rate of 54 beats per minute, and warm, dry skin. Which type of shock best explains these findings?
- A Neurogenic shock ✓
- B Cardiogenic shock
- C Hypovolemic shock
- D Septic shock
Correct answer: A. Neurogenic shock
Explanation
Neurogenic shock results from loss of sympathetic tone, causing vasodilation and unopposed parasympathetic activity. The hallmark is hypotension with bradycardia due to disruption of the cardioaccelerator fibers. The skin is warm and dry because of loss of sympathetic vasoconstrictor tone. Hypovolemic shock causes tachycardia, cardiogenic shock causes pulmonary congestion, and septic shock causes tachycardia with high cardiac output.
Reference: Bailey & Love's Short Practice of Surgery, 28th ed.
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Written and medically reviewed by the StethoPrep medical team.