Autonomic Dysreflexia Essay

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Autonomic Dysreflexia following Spinal Cord Injury Anne Gunn 1/24/12 Intensive Care Unit at the VA Medical Center Attending: Dr. Clement Singarajah ABSTRACT: Autonomic dysreflexia (AD) is a serious condition that can occur at any time following a spinal cord injury at or above the level of T6, the location of splanchnic sympathetic outflow (1). It results in the loss of coordination on autonomic regulation, leading to uncontrolled heart rate, blood pressure and vascular tone. Prompt recognition and treatment of this condition is important due to the detrimental effects uncontrolled blood pressure can have on the body. It is important that patients with spinal cord injuries and those that care for them are aware of this syndrome and the urgency of seeking immediate medical attention. The etiology of autonomic dysreflexia includes a range of noxious stimuli including bowel obstruction, gastric or bladder distension, sexual activity, labor, bone injury and any disruption to visceral structures (2). Complications from autonomic dysreflexia are a result of sustained hypertension and its physiologic effects on end organs such myocardial infarctions, seizures and hemorrhage of the brain and/or retina. Although mortality is uncommon with this condition, the morbidities are high and luckily, can be prevented with early detection and correction (2). INTRODUCTION: Patient JC is a 44 year old male with C6 quadriplegia from a parachute malfunction 6 years ago. He has a history of neurogenic bowel and bladder status-post colostomy and suprapubic catheterization. He presented with a progressively worsening abdominal pain, distension and elevated blood pressure far above his baseline. With his history of spinal cord injury and hypertensive state, autonomic dysreflexia was an immediate concern. He was promptly admitted to the Intensive Care Unit and worked up

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