Autonomic dysreflexia: one more way EMS can positively affect patient survival.
Autonomic dysreflexia is a life-threatening medical condition that affects people with spinal cord injuries above T6. Caused by the division of the autonomic nervous system, it can result in disastrous hypertension. Although complicated in nature, AD can be quickly treated and reversed by prehospital providers. The prompt emptying of a patient's bladder and/or bowels will resolve most occurrences. Other factors that can't be resolved in the prehospital setting may cause AD. In these situations, quickly transport the patient to a definitive care facility and consider the use of antihypertensive agents. Bladder catheterization and digital bowel emptying are not everyday EMS skills. They are, however, skills within the range of EMS abilities. Providers should contact their medical directors or training supervisors to obtain the training necessary to carry out both techniques. Having these skills will arm you with the necessary abilities to mitigate an episode of autonomic dysreflexia.
Tomassoni
Paul J
PJ
teach@friend.ly.net
Campagnolo
Denise I
DI
D000328:Adult; D020211:Autonomic Dysreflexia / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D001342:Autonomic Nervous System Diseases / Q000150:complications; D001794:Blood Pressure / Q000502:physiology; D004634:Emergency Medical Technicians; D004638:Emergency Treatment / Q000379:methods*; D005244:Fecal Impaction / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008297:Male; D010829:Physiological Phenomena; D013119:Spinal Cord Injuries / Q000150:complications; D013534:Survival; D014546:Urinary Catheterization; D014910:Wheelchairs