A 22-year-old man sustains severe blunt trauma to the back. He notes that he cannot move his lower extremities. He is hypotensive and bradycardic. Which of the following is the best initial management of the patient?
The patient is in neurogenic shock as a result of a spinal cord injury. Neurogenic shock is characterized by loss of sympathetic tone peripherally as well as bradycardia owing to loss of the reflexive increase in hea rate in response to hypotension. Initial treatment is with fluid resuscitation followed by initiation of vasoconstrictors such as dopamine or phenylephrine. Hypovolemia caused by hemorrhage should also be ruled out in trauma patients
Administration of phenylephrine
Administration of dopamine
Administration of epinephrine
Intravenous fluid bolus
Miscellaneous