In autonomic dysreflexia, which of the following symptoms do patients typically experience?A. Flushing above the level of the injury, hypertension, reflex bradycardia and headache
Autonomic dysreflexia is a life-threatening emergency which can occur in patients with spinal cord injuries (SCI) at or above T6. There is massive sympathetic discharge of the distal autonomous cord (i.e., below the level of the spinal cord injury) secondary to specific stimulus. Ordinarily the reflexes would be inhibited by output from the medulla but in SCI this does not happen and leads to autonomic dysreflexia.
The most common cause is bladder distension due to a blocked catheter, cystoscopy or urodynamics. Other causes include faecal loading, skin, and urine infections. Symptoms are flushing and sweating of skin above the level of injury, hypertension with reflex bradycardia and headache. The crucial step is to identify it, remove the offending stimulus, sit the patient up and administer 10 mg nifedipine to chew, not sublingually. Blood pressure must be monitored throughout.