Snap Shot Patient has hypotension without tachycardia and without a narrowed pulse pressure. Introduction Spinal cord injury leading to loss of autonomic innervation leads to blood pooling in splanchnic bed and muscle Presentation Hypotension without tachycardia (low - low think neuro) No narrowed pulse pressure Signs of spinal cord injury (torso trauma) Differential Filling Pressure (RA and PCWP) Cardiac Output Vascular Resistance Septic shock Low Increased Low Cardiogenic High Low High Hypovolemic Low Low High Cardiac tamponade High Low High Papillary muscle rupture High Low High Treatment/Management Usually self-limited Usually can be managed by placing patient supine or in Trendelenburg position