Quick Chart
  • Occurs after an injury to the spinal cord. Sympathetic outflow is disrupted resulting in unopposed vagal tone.

Read the complete article; Shock in the Medical Library >  Pathophysiology.

Clinical Presentation
  • Decreased mental status
  • Symptomatic hypotension
  • Bradycardia (dependant on level of injury)
  • Skin: warm & dry
Exclusion Criteria
Exclusion Criteria
Risk Assessment
  • Respiratory depression
  • Hypothermia
  • Neurogenic shock is usually self-limiting, caused by dilation of the vascular bed. 
  • Little is needed for neurogenic shock as they are usually well perfused.
  • Beware of fluid overload
  • Neurogenic shock must be differentiated from "spinal" shock. Spinal shock is defined as temporary loss of spinal reflex activity occurring below a total or near-total spinal cord injury.
Primary Care
Intermediate Care (EMT / Level 2)
  • Apply cardiac monitor if trained and authorised
  • Apply spinal precautions as per CPG if indicated
  • Monitor patient persistently, recording full observations every 10 minutes (or 5 minutes if time critical)
  • Transport Priority 1 if patient time critical, pre-notifying receiving facility
Advanced Care (AP)
Critical & Extended Care (CCP, PSO)
  • As per Advanced Care (AP) guidelines
Additional Information
  • Clinical deterioration
  • Hemodynamic instability
  • Dysrhythmias
  • Cardiac Arrest

Key Terms & Links
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Responsible Manager
Head of Clinical Services

Published Date

Review Date

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