Which set of signs is associated with neurogenic shock?

• A. Cold skin, tachycardia, sweating
• B. Warm skin, normal heart rate, paralysis
• C. Damp skin, irregular pulse, chest pain
• D. Cool skin, hypertensive pulse, agitation

Answer: (B)

Neurogenic shock happens when a spinal cord injury disrupts the sympathetic nervous system’s control of blood vessels. Without that sympathetic tone, vessels dilate widely, blood pools in the periphery, and blood pressure falls. That vasodilation also makes the skin warm and dry rather than clammy. If the injury involves the spinal column, paralysis may be present, which further points to a spinal injury as the trigger for the shock.

The warm skin described in the option reflects the vasodilation from loss of sympathetic tone, and the presence of paralysis supports a spinal-origin problem. The heart rate in neurogenic shock can be bradycardic or occasionally normal, depending on the exact situation and level of injury, so a normal heart rate does not rule it out. Put together, warm skin with paralysis aligns with neurogenic shock more than the other scenarios, which show signs of cold skin or other shock types.

In contrast, cold skin suggests vasoconstriction from other shock types (like hypovolemic or cardiogenic), damp skin with chest pain points away from neurogenic shock, and a cool skin with agitation and high blood pressure doesn’t fit the typical pattern of neurogenic shock.