First Aid Recognition and Management of Neurogenic Shock

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Neurogenic shock is a medical emergency that occurs after damage to the central nervous system affecting the nerves that make up the autonomic nervous system.

Neurogenic shock is a medical emergency that occurs after damage to the central nervous system, which is comprised of the brain and the spinal cord. It is a type of distributive shock, wherein shock results from the misdistribution of blood flow to the tissue. The irregularities in blood flow distribution may lead to great inadequacies in tissue oxygenation, despite normal cardiac output. Neurogenic shock is different from spinal shock, which pertains to loss of function due to spinal injury.

Neurogenic shock typically affects the important nerves that compose of the autonomic nervous system, which affects heart rate and other involuntary functions of the body. When there is injury to the nerves, the blood vessels walls begin to relax, resulting to hypotension (low blood pressure) and bradycardia (decreased heart rate). This may decrease the heart’s ability to adequately pump blood. Moreover, due to the decreased systematic vascular resistance (resistance to flow that must be overcome to push blood through the circulatory system), less oxygen-rich blood is delivered to the organs.

Causes of Neurogenic Shock

The following may lead to neurogenic shock in the body:

  • Damage or trauma to the brain or spinal cord
    • Blunt injuries, such as car accidents, etc.
    • Penetrating injuries, such as gunshot wounds, etc.
    • Certain drugs that may affect the autonomic nervous system
    • Improperly administered regional anaesthesia

Signs and Symptoms of Neurogenic Shock

Neurogenic shock and other types of distributive shock have a unique characteristic that is only found in their type. This sign is the warm, dry skin, whereas in other types of shock, skin is usually pale, cool and clammy. Other signs and symptoms of neurogenic shock include:

  • Low blood pressure
  • Bradycardia
  • Weak pulse
  • Patient may feel cold
  • Little or no urine output
  • Dizziness
  • Confusion and anxiety

First Aid Management for Neurogenic Shock

Neurogenic shock is a medical emergency. If an individual begins to show signs and symptoms of neurogenic shock, call for emergency medical services or bring the victim to the nearest emergency room. While waiting for the paramedics, administer first aid to avoid complications from developing. The following steps are generally recommended in cases of neurogenic shock:

  • Immobilise the spine to avoid any further damage. Avoid moving the victim unless there is danger in the immediate environment.
  • Check the victim’s circulation, airway and breathing. If necessary, begin rescue breathing and CPR.
  • Constant check rate of breathing every five minutes even if the victim is capable of breathing on his or her own.
  • If there is vomiting or drooling, hold the person’s head, neck and back in a line and roll the victim to the side as a unit, similar to a log.
  • Loosen any tight clothing.

Disclaimer: This article does not provide medical advice and should not be substituted for formal training. The information given should not be used for self-diagnosis. Seek medical attention when necessary. It is important to recognise medical emergencies at all times to avoid complications from developing. To learn more about to how to treat and manage neurogenic shock victims, enrol in Canadian or American Heart Association approved first aid and / or CPR training.


Chapter 29: Shock States. (ND). Expert Consult. Retrieved October 16, 2013, from–s0160&isbn=978-0-323-07307-3

Nakhoda, Nisreen. (2013). Neurogenic shock – Causes, diagnosis and treatment. Retrieved October 16, 2013.

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