A 23-year-old patient has arrived at the emergency department following a motor vehicle accident. The patient exhibits bradycardia, hypotension, and warm, dry skin. Which intervention is the BEST initial step in managing suspected neurogenic shock in this patient?
Intravenous fluid administration
Immediate administration of high-dose methylprednisolone
Intravenous fluid administration is the most appropriate initial step in the management of neurogenic shock. Neurogenic shock is characterized by the loss of sympathetic tone following a spinal cord injury, which leads to vasodilation, decreased systemic vascular resistance, and resulting hypotension. While atropine and vasopressors may also be used, they are typically secondary interventions after adequate fluid resuscitation has been initiated to restore intravascular volume. High-dose methylprednisolone is not recommended as a first-line treatment due to lack of evidence supporting its use in acute spinal cord injury and potential for harm.
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Neurological Emergencies
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