Shocking Situations
The triad of hypotension, bradycardia, and poikilothermia (warm, dry skin).
What is neurogenic shock?
An injury at this level or above typically results in total loss of respiratory muscle function, requiring mechanical ventilation.
What is C1-C4?
The #1 priority for a patient with a suspected C-spine injury in the field.
What is airway (with C-spine stabilization)?
The first, immediate nursing action you take when you suspect Autonomic Dysreflexia.
What is: Sit the patient up (High-Fowler's)?
The priority intervention to prevent this most common and deadly long-term complication: pressure ulcers.
What is a frequent turn/repositioning schedule?
The type of shock characterized by a temporary loss of all reflex activity below the injury.
What is spinal shock?
This landmark is the "line" for Autonomic Dysreflexia. Injuries above it are at high risk.
What is T6?
The maneuver used to open the airway of an SCI patient instead of a head-tilt/chin-lift.
What is the jaw-thrust maneuver?
The three classic, "can't-miss" symptoms of Aut…"A.D."
What are: severe pounding headache, dangerously high BP, and bradycardia? (Also accept profuse sweating above lesion, flushing).
This "neurogenic" complication requires a strict intermittent catheterization or indwelling catheter program.
What is a neurogenic bladder?
This type of shock is caused by a loss of sympathetic tone, leading to massive vasodilation.
What is neurogenic shock?
A patient with full arm and hand control, but with paralysis from the waist down.
What is a Thoracic or Lumbar injury (paraplegia)?
The standardized scale used to grade the motor and sensory level of an SCI.
What is the ASIA scale?
The single most common cause of an A.D. episode.
What is a distended bladder? (e.g., kinked Foley).
Patients are at high risk for these blood clots due to immobility and loss of muscle pump function.
What are DVTs (Deep Vein Thrombosis)?
We treat the bradycardia in neurogenic shock with this medication.
What is atropine?
A patient can shrug their shoulders (C4 - Trapezius) and bend their elbows (C5 - Biceps), but cannot extend their wrist or use their hands.
What is C5 or C6 injury?
To prevent secondary injury, we "perfuse the cord" by maintaining a target MAP of this for 5-7 days.
What is 85-90 mmHg?
The second most common cause of an A.D. episode.
What is bowel impaction?
The term for involuntary, spastic muscle movements that can occur as spinal shock resolves.
What is spasticity?
This drug can be used to increase blood pressure in patients with neurogenic shock?
What is Phenlyeprhine or Norepinephrine?
Injury at this level will lead to paralysis starting at the Hip and groin region.
What is L1-L2?
This steroid, while controversial, is sometimes given in high doses within 8 hours to decrease cord inflammation.
What is Solu-Medrol (methylprednisolone)?
If sitting the patient up and fixing the cause doesn't work, this rapid-acting class of medication is given IV to lower BP.
What are vasodilators? (e.g., Nitroglycerin, Hydralazine).
This chronic, non-nociceptive pain is often described as burning, tingling, or "pins and needles" at or below the injury level.
What is neuropathic pain?