Hi! This is Dr. Carmen Corder with thedrnurse.com In this video I want to talk about two types of shock that you will see in spinal cord injury patients Both of these types of shock that I'm going to talk about The video will be included in the Neuro Disorders Pathopedia eBook The video will be included in the Neuro Disorders Pathopedia eBook The patho of the two types of shock Detailed patho, signs and symptoms, priority assessments, and interventions Neurogenic shock and spinal shock Sometimes students will get these confused, but they are very very different disorders So just a real simple memory trick to help you Think of with neurogenic shock the nervous system is in shock Okay, neurogenic the entire nervous system with spinal shock It's just the spinal cord. Okay, and the the tasks that the spinal cord is supposed to accomplish so with neurogenic shock Spinal cord is the main cause of shock Neurogenic shock is a high level spinal cord injury usually above the level of T6 that places spinal cord injury patients at risk for complications So you have a very acute high level spinal cord injury and what happens as the spinal cord is the information highway if you will relaying The brain is sending messages and input from the periphery to the brain and then sending a response from the brain back out to the muscles and the tissues in the periphery With this neurogenic shock, there is a disruption of the sympathetic nervous system messages that are being relayed from the levels of T1 all the way down to L2 Loss of sympathetic nervous system stimulation with neurogenic shock So with loss of sympathetic nervous system stimulation or the SNS you lose those fight-or-flight hormones Epinephrine and norepinephrine Loss of epinephrine and norepinephrine If you lose epinephrine and norepinephrine, you will experience the opposite The patient will experience significant bradycardia due to the loss of epinephrine and significant hypotension due to vasodilation due to the loss of norepinephrine Those are the two big signs and symptoms of neurogenic shock Neurogenic shock is a priority for all spinal cord patients Maintain the airway and breathing Cervical spine precautions need to be thrown in there as necessary Maintain blood pressure Massive vasodilation and bradycardia Treat atropine and hypotension with fluids Keep the MAP 80-85 Neurogenic shock Spinal shock Spinal cord injury can occur anywhere along the spinal cord With spinal cord injury, bleeding and inflammation causes tissue damage Damaged tissue releases chemical media Chemical mediators cause vasoconstriction Spinal Port Ischemia Spinal cord ischemia and hypoxia Spinal cord ischemia and hypoxia Spinal cord that is not receiving blood flow that is not oxygenated is not going to do its job properly It results in paralysis loss of sensation below the level of injury loss of sensation below the level of injury Depending on the type of spinal cord injury and the significance Compression and once that inflammation and bleeding is relieved and the pressure is relieved off of that area Then that's when the patient will regain feeling movement sensation Below the level of that injury and so again both of these types of shock are detailed thoroughly in the soon to be released neuro pathopedia ebook and also you're gonna Keep an eye out for the Neurological Disorders Pathopedia eBook!