Autonomic dysreflexia can occur in persons with a spinal cord injury (SCI) above T6. This can be life threatening because of elevated blood pressure.
Signs and Symptoms
High blood pressure; severe/pounding headache; goose bumps above level of injury, sweating above level of injury; flushing or pallor; stuffy nose; nausea or vomiting; “not feeling right”.
Full bladder, full bowel, skin sore, ingrown toenail, irritation or tight clothing, but could be anything that would have caused pain below level of injury prior to injury.
Check Blood pressure
Sit up as straight as possible, remove abdominal binder or any other tight clothing (e.g., TED Hose, shoes)
Indwelling catheter (foley, suprapubic):
Check all tubings for kinks or a full bag
Flush catheter. If nothing returns or if unable to flush, then change catheter
Intermittent catheter program:
Check bowel for fullness:
Insert xylocaine jelly into rectum
Gently remove stool, if present
Check skin for sores, ingrown toenails, trauma (broken bone or severe cut). Tests and procedures can also trigger Autonomic Dysreflexia (cysto, gynecology exam).
If above treatments fail to bring BP down:
Go to the nearest emergency room
Give them this information
This hypertension should be treated medically
Apply nitroglycerine paste 1 – 2 inches to skin every 2 hours. May wipe off if blood pressure is stable. Reapply if needed. Nifedipine 10 mg capsule (immediate release form). May repeat in 20 – 30 minutes, if necessary. Avoid sub-lingual, which can cause abrupt hypotension.
Check blood pressure at least every 3 minutes. It can change rapidly.
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