In neurogenic shock, what is the sign above the injury site?

• A. Warm, flushed
• B. Cold and numb
• C. Red and swollen
• D. Cool, pale, diaphoretic

Answer: (D)

Neurogenic shock is due to loss of sympathetic tone below the injury, which causes widespread vasodilation there and a warm, dry appearance. Above the injury, sympathetic control remains intact, leading to vasoconstriction and signs of poor perfusion such as cool, pale skin, often with diaphoresis. So the skin above the injury being cool, pale, and diaphoretic best fits the expected pattern. The warm, flushed skin describes areas below the injury, not above.