Clinical Pathways
Clinical Pathways
Cervical Spine Injuries
Cervical Spine Injuries

Cervical Spine Injuries

Tags
Emerg. Med. Practice
Published
October 1, 2021
Author(s)
Geoffrey Jara-Almonte, MD; Chandni Pawar, MD

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Action

Patient presents to ED with blunt trauma and concern for cervical spine or cord injury

Decision

Is patient stable and without signs of neurogenic shock?

Background

SCI may precipitate neurogenic shock due to interruption of the sympathetic fibers exiting from the T1-T4 levels, with resulting loss of vasomotor tone and cardiac output. The incidence of neurogenic shock has been reported to be as high as 43% in patients with cervical and high thoracic SCI, but there is no single agreed-upon definition of the condition.

Do not allow warm extremities or the absence of tachycardia to be falsely reassuring; these are features of neurogenic shock.

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References
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