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911!! Preventing, Identifying, and Treating Autonomic Dysreflexia

911!! Preventing, Identifying, and Treating Autonomic Dysreflexia

By Kevin Cleary

There are numerous issues that can develop after suffering a spinal cord injury that can impact your life negatively. Besides the obvious lack of mobility, maladies such as pressure sores, bowel and bladder complications as well as what might seem as innocuous illnesses or injuries may cause someone suffering from SCI major problems. With the spinal cord injured, our nervous system does not respond properly to stimuli. Recovery from these afflictions can be slower, but more importantly can cause the onset of autonomic dysreflexia. This is a true 911 moment and can be life-threatening!!

911!! Preventing, Identifying, and Treating Autonomic Dysreflexia

Identifying Autonomic Dysreflexia

If you are someone living with a spinal cord injury you have heard the term autonomic dysreflexia, but what exactly is it? Autonomic dysreflexia is a syndrome in which there is a sudden onset of extremely high blood pressure, as defined by webMD.com. Those suffering from a spinal cord injury at the T6 cervical level and above are more susceptible. This condition can also be called autonomic hyperreflexia. Basically, it is an abnormal overreaction of the central nervous system to some form of stimuli. It can be triggered by something as simple as a hangnail or sunburn, but it can also be a sign of something more serious such as a brain hemorrhage or blocked bowels. Basically, uncontrolled hypertension is caused by the body’s improper response up and down the spinal cord to malicious stimuli. Once it has been determined that you are indeed experiencing an AD moment, it is important to get immediate medical help, such as 911. Autonomic dysreflexia can be a life-threatening event!!

Symptoms of AD

Knowing what AD is gives only half of the picture. Being able to identify the symptoms that accompany it can help reverse the syndrome. With the cute onset of extremely high blood pressure, a tremendous pounding headache can be a sign of autonomic dysreflexia. One way to check to see if your blood pressure is dangerously high is to use the A & D Medical Quick Response Blood Pressure Monitor so treatment can begin immediately. It is easy to use, fits most arms, and keeps a record of blood pressure history. It even has three programmable alarms so you can set your danger threshold. If you are out and about, the Invacare Deluxe One Touch Digital Wrist Blood Pressure Monitor Kit can be easily taken with you in order to get a fast, accurate reading. Another way to tell that you may be in danger is excessive sweating above your level of injury, along with dilated pupils, a stuffy nose, and flushed face. Below the level of injury, you may experience a reduced heart rate, possibly goose bumps accompanied by cold and clammy skin. Understanding what these symptoms may mean can be the difference between life and death.

Act Fast!!

911!! Preventing, Identifying, and Treating Autonomic Dysreflexia

Okay, you’re involved in an autonomic dysreflexic moment; what do you do? Since uncontrolled hypertension is at the crux of this dilemma, that is where we need to start first. By sitting the patient up immediately this takes advantage of gravity pulling blood to the lower extremities. Use of a hospital bed while sleeping, such as the Drive Full-Electric Hospital Bed can expedite raising the head to lower blood pressure to safe levels. If an AD moment should occur in the shower, the use of a reclining shower chair can help upright a patient quickly. The Duralife Reclining Shower Chair can not only recline for easy showering, but can get the patient into an upright seated position quickly and easily. The most common culprit for an onset of AD is the urinary tract. A vigilant inspection of any indwelling or Foley catheter should make sure there is no blockage or kinking of the line. If the patient does not have an indwelling catheter they should be catheterized immediately using an intermittent catheter. Any bowel or bladder program that is rigorously followed can minimize the risk of autonomic dysreflexia. The use of suppositories can help expel impacted stool. One example that can help is the Magic Bullet Suppository , which uses a polyethylene glycol base and is water-soluble. The Therafin E-Z Reach Suppository Inserter and Digital Bowel Stimulator makes insertion simple and expedites bowel movements by stimulating the sphincter muscle. The AD episode will subside once the offending stimulus is removed.

Avoiding AD

The best way to overcome an episode of autonomic dysreflexia is to avoid it altogether. While this may not be possible all the time, a little bit of prevention can go a long way. Making sure catheters are changed regularly can help prevent an episode from arising due to a clogged catheter. If straight catheterization is your go to plan, then doing it every 4-6 hours is best. Making sure that any catheter is properly lubricated is important. One suggestion is to use lubricant such as the Nycomed Fougera Surglube Lubricating Jelly . Establishing a bowel program to evacuate fecal matter cannot be understated. Bowel blockages or constipation can lead to episodes of AD. Enemeez Plus Mini Enemas is an anesthetic stool softener laxative that can be used in any bowel program and minimizes irritation leading to autonomic dysreflexia. To help facilitate this, the use of an anesthetic lubricating jelly is good. Making sure we identify the symptoms and understanding how to deal with autonomic dysreflexia can be a life-saving skill for patients and caretakers alike. By following just a few simple safety guidelines AD and its dangers can be minimized.

 

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