Our spinal cord is essential in providing 2-way communication from our brain to all areas of our body. When a spinal cord injury occurs, whether it is due to an accident or illness, that communication is broken down and can lead to complete, or partial, loss of movement and sensation in the affected parts of the body.
It’s estimated there are 50,000 people in the UK living with a spinal cord injury and each year there are around 2,500 people who are newly injured. A spinal cord injury is a life changing occurrence. It can affect mobility, bladder & bowel function as well as sexual function. The effects of the injury will vary according to the level at which the spinal cord is damaged.
Many people who have suffered a spinal cord injury at T6 (Thoracic vertebrae) or above can potentially suffer with a condition called Autonomic Dysreflexia and it is really important that nurses and doctors, as well as patients, are aware of the condition and know how to treat it.
“Autonomic dysreflexia (AD) is a potentially life-threatening medical emergency.”
AD is triggered by a painful stimulus below the level of injury which then causes severe, sudden hypertension (high blood pressure) and must be treated promptly. Most people can easily treat and even prevent AD. The crucial thing is to know their normal blood pressure, their triggers and their symptoms.
Possible Causes
AD is caused by a stimulus below the level of injury and is often related to the bladder or bowel. This could be a urine infection, blocked catheter, full bladder, distended bowel, bladder/kidney stones, constipation or haemorrhoids. Other causes might include pressure sores, ingrown toenails, burns to the skin including sunburn, fractures, sexual activity, menstrual problems or having a baby. Family and carers must be informed of the possible causes and treatment options for AD. If it is quickly recognised and treated immediately, the symptoms can subside, and complications can be avoided.
Signs of AD
Symptoms of AD include sudden onset of a thumping headache, high blood pressure (normal blood pressure for spinal injury patients, especially tetraplegics, is usually low and can be in the region of 90/60 lying down), flushed skin and sweating above injury level, goose bumps below injury level, nasal congestion, slow pulse rate <60bpm, nausea and anxiety.
What to do
A quick response is essential, so you need to sit up, lower your legs if possible, loosen any tight clothing and locate and remove whatever is causing the problem. Monitor blood pressure if possible and take medication if it has been prescribed (and you cannot find and treat the cause) and blood pressure is not going down.
If you cannot locate and treat the cause, seek prompt medical attention (Dial 999)