Neurogenic Shock Vasopressor — FRCA Final MCQ

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ModerateTrauma & Emergency AnaesthesiaNeurogenic Shock VasopressorFRCA Final

High C4 spinal cord injury: HR 42, BP 65/35, warm well-perfused peripheries. After 2L crystalloid no improvement. Best vasopressor?

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Correct answer: C — Noradrenaline

Neurogenic shock: loss of sympathetic tone → vasodilation (warm peripheries) + unopposed vagal → bradycardia. Noradrenaline first-line: alpha-1 vasoconstriction + beta-1 chronotropy addresses both. Phenylephrine worsens bradycardia. Target MAP ≥85 for 7 days.

Reference: NICE – 2023 – NG41 Spinal injury