Neurogenic shock & Automatic Dysreflexia Flashcards
Are neurogenic shock and autonomic dysreflexia the same thing?
No
What is Neurogenic shock?
Loss of ANS control due to a spinal injury - parasympathetic and sympathetic.
What symptoms define neurogenic shock?
Bradycardia and Hypotension
Flushed, warm skin
What happens in neurogenic shock if the injury is below the 5th vertebrae?
Diaphragmatic breathing
Neurogenic shock with an injury above the 3rd vertebrae is concerning why?
Respiratory arrest occurs immediately
What pressors do we use for neurogenic shock?
Dopamine
Vasopressin
Phenylphrine (if dopamine doesn’t work)
What med do we use for neurogenic shock if HR is too low and we need it to pick up?
Atropine
Since neurogenic shock is shock, what else do we monitor for cardiac output readings?
UO and bowel
How do we monitor the UO?
Foley - to see how the kidneys perfuse
If no foley, we check for residual
How do we address bowel issues with neurogenic shock injuries?
Stool softener
Digital stimulation
What is Autonomic Dysreflexia?
Complication of an injury at T6 or above that leads to marked hypertension
What triggers the Autonomic Dysreflexia?
Distended bladder
Full rectum
Infection
Pressure ulcers
Pain
Other symptoms of autonomic dysreflexia?
SOB, HA, congestion
Blurry vision, facial flushing, diaphoretic
Pilo-erection, anxiety
You see your patient with an injury above T6 has marked hypertension. What do you do?
You know its autonomic dysreflxia - and so you have them sit down immediately.
How do you treat autonomic dysreflexia?
You treat the cause - better yet prevent it from ever happening too.
Prevent the bladder and bowel problems.
