How are hypotension, hemorrhage, and shock in spinal cord injury (SCI) assessed?

Updated: Nov 01, 2018
  • Author: Lawrence S Chin, MD, FACS, FAANS; Chief Editor: Brian H Kopell, MD  more...
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Answer

Hypotension may be hemorrhagic and/or neurogenic in acute spinal cord injury. Because of the vital sign confusion in acute spinal cord injury and the high incidence of associated injuries, a diligent search for occult sources of hemorrhage must be made.

The most common sources of occult hemorrhage are injuries to the chest, abdomen, and retroperitoneum and fractures of the pelvis or long-bones. Appropriate investigations, including radiography or computed tomography (CT) scanning, are required. In the unstable patient, diagnostic peritoneal lavage or bedside FAST (focused abdominal sonography for trauma) ultrasonographic study may be required to detect intra-abdominal hemorrhage.


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