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What is Autonomic Dysreflexia?
Autonomic Dysreflexia (AD), sometimes referred to as Autonomic Hyperreflexia, is a condition which may occur in people with spinal cord injuries above the level of T6 where there is an increase in blood pressure in response to a painful stimulus from below the level of injury which the person may not be able to feel.
Symptoms may include:
- Hypertension – Systolic Blood Pressure rise >20-40mmHg above baseline
- Bradycardia (slow heart rate) or sometimes Tachycardia (high heart rate)
- Pounding Headache
- Facial flushing/sweating
- Apprehension/anxiety
- Goosebumps
- Nasal congestion
- Nausea
- Chills (no fever)
- Blurred vision
- Above injury: Sweating, warm skin
- Below injury: pale, cool, clammy skin
What to do in case of autonomic dysreflexia
- Sit the person upright.
- Loosen clothing. Remove abdominal binder, compression socks, anything restrictive such as resting hand splints, belt, leg bag, etc.
- Search for cause.
- Bladder: Empty - catheterize, or if indwelling catheter present, flush/reposition or exchange to ensure proper drainage
- Bowel: Rectal check (stop if worsening symptoms), remove stool if present, use topical lidocaine if available. Complete bowel program if no recent bowel movement.
- Check skin: Look for wound, ingrown toenail, new bruising, reposition off any wounds or discolored skin
- Check BP every 15 minutes. If symptoms continue or worsen, or no cause is found, seek immediate medical attention. Follow your physician’s instructions such as administering pain or BP medications.
MSKTC Fact Sheet: Autonomic Dysreflexia
MSKTC Fact Sheet and Wallet Card: Autonomic Dysreflexia (508 Compliant Version)
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