Autonomic Dysreflexia: An Update, How Serious Is It?

Monday, 9 November 2015

Julius H. Penning, MSN/ED, RN, CRRN1
Lavonya L. McAlister, BSN, RN1
Sandra Iwunze, BSN, RN2
(1)SCI Care Line, Michael E. DeBakey VAMC, Houston, TX, USA
(2)Spinal Cord Injury Care Line, Michael E. DeBakey VAMC, Houston, TX, USA

Autonomic Dysreflexia (AD) is a medical emergency for individuals who have sustained a spinal cord injury (SCI) at or above the thoracic sixth vertebrae (T-6), which can cause complications with seizures, stroke, cardiac complications or death if not treated. The general public, family physicians, non-rehabilitation hospitals, Emergency Departments and rehabilitation hospitals for spinal cord injury play a crucial role in maintaining the health care and well-being for SCI individuals. Male-to-female ratio for SCI is 4:1; however AD is not sexually predetermined. SCI complete injuries (no motor or sensation) have a higher risk for experiencing AD, 91% vs 27% for incomplete SCI. Although motor vehicle crashes are still the most common cause of SCI, an alarming rate of falls in the elderly (individuals over the age of 60) over the past three decades by far are the fastest growing age group of individuals sustaining spinal cord injuries. Cervical injuries are greater than 56.5%. Individuals are presenting with cervical stenosis and often require rehabilitation for a SCI due to injury to the spinal cord. Increasing knowledge for individuals at risk with a SCI at or above T-6, medical staff, family members, care providers and  the general public is critical to maintaining the health and well-being of individuals who are at risk for AD.