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Responding to the Risks of Autonomic Dysreflexia


Illustration of the human spine, highlighting different sections in distinct colours. The cervical vertebrae are in blue, thoracic vertebrae in pink, lumbar vertebrae in green, and sacrum and coccyx in yellow. The image shows the spine from the back view with skeletal features, including ribs and pelvis.
The human spine: A colourful journey through the cervical, thoracic, lumbar, and sacral regions.

Autonomic dysreflexia (AD) is a serious condition that can affect individuals with spinal cord injuries, particularly those with injuries at or above the T6 level. It is characterised by a sudden and dangerous increase in blood pressure in response to stimuli below the level of injury. At ENA Care Group, we are dedicated to providing comprehensive support to individuals at risk of AD, ensuring prompt recognition and effective management to safeguard health and well-being.


Understanding Autonomic Dysreflexia

AD occurs when a noxious stimulus below the level of spinal injury triggers an excessive autonomic response, leading to acute hypertension. Common triggers include bladder distension, bowel impaction, pressure ulcers, tight clothing, and sudden temperature changes. Recognising these triggers is crucial for prevention and management.


Recognising the Symptoms

Symptoms of AD can vary but often include:

  • Severe, pounding headache

  • Profuse sweating above the level of injury

  • Flushed skin or blotchiness above the injury

  • Goosebumps below the level of injury

  • Nasal congestion

  • Nausea

  • Bradycardia (slow heart rate)

  • Blurred vision

Immediate recognition of these symptoms is vital to initiate prompt treatment and prevent serious complications such as stroke or seizures.


Immediate Management of Autonomic Dysreflexia

If an episode of AD is suspected, the following steps should be taken promptly:

  1. Sit the individual upright to lower blood pressure.

  2. Loosen any tight clothing or accessories.

  3. Check for and alleviate potential triggers, such as:

    • Bladder distension: Ensure catheter patency or perform intermittent catheterisation.

    • Bowel impaction: Perform gentle rectal examination if trained to do so.

    • Skin issues: Inspect for pressure sores or ingrown toenails.

  4. Monitor blood pressure every 5 minutes.

  5. Administer prescribed antihypertensive medication if blood pressure remains elevated.

  6. Seek emergency medical assistance if symptoms persist or worsen.

Our carers are trained to implement these interventions swiftly and effectively, ensuring the safety and well-being of our clients.


Preventative Strategies

Preventing AD involves proactive management and awareness of potential triggers. At ENA Care Group, we develop personalised care plans that include:

  • Regular bladder and bowel management to prevent distension or impaction.

  • Routine skin assessments to identify and address pressure areas promptly.

  • Ensuring clothing and medical devices are appropriately fitted to avoid constriction.

  • Educating clients and families about recognising early signs and triggers of AD.

By adhering to these strategies, we aim to minimise the occurrence of AD episodes and enhance the quality of life for our clients.


Our Commitment

At ENA Care Group, we are committed to providing high-quality, personalised care for individuals with spinal cord injuries. Our carers are extensively trained to recognise and manage autonomic dysreflexia, ensuring prompt and effective responses to safeguard our clients' health. We work closely with healthcare professionals to develop and implement comprehensive care plans tailored to each individual's needs.

For more information on how ENA Care Group can support you or your loved one, please contact us at 01707 333700 or email care@ena.co.uk.

(From 2021)


 
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