Paramedic National Registry Practice

What type of shock is characterized by hypotension and warm, flushed skin after a car accident into a pool?

1. Cardiogenic shock

2. Hypovolemic shock

3. Neurogenic shock

4. Anaphylactic shock

The correct answer is: Neurogenic shock

Neurogenic shock occurs when there is a sudden loss of sympathetic nervous system signals, which leads to vasodilation and a decrease in systemic vascular resistance. Following a car accident, the trauma can result in damage to the spinal cord or neurological pathways, which may trigger this physiological response. As a result, a patient in neurogenic shock may present with hypotension due to the inability of the blood vessels to constrict properly, alongside an unusual presentation of warm and flushed skin caused by excess blood pooling in the dilated vessels. This demarcation from other types of shock is particularly important; unlike hypovolemic shock, where the body is losing blood volume, or cardiogenic shock, where the heart fails to pump effectively, neurogenic shock is specifically associated with spinal injuries impacting the nervous system's ability to regulate blood vessel tone. The presence of warm, flushed skin helps to differentiate this type of shock from others, highlighting the unique characteristics that define neurogenic shock in emergency medical situations.