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What to Do if You Experience Autonomic Dysreflexia

Tree by: KMT Physical Health May, 2021 5 min read

Autonomic dysreflexia is a serious medical condition. However, there are a few steps you or your carer can take immediately if you suspect you may be experiencing it.

If you have a spinal cord injury, you may be at risk of developing autonomic dysreflexia. This condition is serious and, left unchecked or unresolved, can cause stroke, seizure or cardiac arrest. In simple terms, autonomic dysreflexia is an overreaction from your body’s autonomic system to something happening below the level of your injury, which can elevate your blood pressure to dangerous levels.

There are many stimuli that can trigger autonomic dysreflexia. Some causes can be easily resolved, whilst others may require a trip to A&E.

Autonomic dysreflexia triggers and your action plan

You’ll find some common autonomic dysreflexia triggers in the table below, alongside some potential remedies. Please note: This is not intended as medical advice and should not replace a formal diagnosis. It is simply general guidance. Please consult your doctor or A&E staff.

Autonomic dysreflexia  triggers

Potential Remedy & Notes

Bladder Issues

Overfull catheter bag

Empty the overfull catheter bag and replace with a new one.

Kinked or blocked catheter hose

Unkink or unblock the obstruction to ensure urine flow into your catheter bag.

Catheter not connected properly

Check your catheter connections and make sure that they are configured correctly.

Damaged or malfunctioning catheter

Replace your catheter product.

Incomplete bladder emptying (IC catheters)

If you use an intermittent catheter, you should stay on your doctor’s recommended schedule..

Bladder or kidney stones

See your doctor for possible medication or surgery

Bladder medical tests

Consult your doctor on the risks of any medical tests that might bring on autonomic dysreflexia. Two tests that are known to have the potential to cause this problem are urodynamics and cystoscopy.

Urinary tract infections (UTIs)

The use of a catheter increases the risk of UTIs. Consult your doctor for treatment and preventative measures. Your medical team may recommend different catheter products, new procedures or a diet change to minimise infections.

Bowel issues

Constipation

Constipation is a common issue for people with a spinal cord injury. Consult with your medical team about treatment.

Hard stools

Consult with your doctor about possible treatments or medication.

Digital stimulation

Digital stimulation done too roughly or without enough lubrication can bring on autonomic dysreflexia. Proceed more gently and use plenty of lubricant.

Bowel infection

If you think you have a bowel infection or food poisoning, see your doctor or visit your closest A&E immediately.

Skin & Skin-related Issues

Tight-fitting clothing, belts, braces and shoes

Loosen or remove any restrictive clothing, braces or shoes.

Pinched or constricted genitalia

Examine your genitalia and loosen any tight undergarments, tights or trousers.

Hard or sharp object pressing against the body

Make sure to remove anything pressing hard against your body below your level of spinal cord injury.

Ingrown toenails

Check your big toes – a common problem area. Many ingrown toenails can be treated by soaking in warm water for 15 to 20 minutes, then placing cotton or dental floss under the toenail. If a home remedy doesn’t work, see your doctor.

Insect bites

A reaction to an insect bite can cause autonomic dysreflexia. There are home treatment options for minor bites; more severe reactions warrant a trip to A&E.

Sunburns or minor burns

Minor sunburn and burns heal on their own. Apply aloe vera lotion or gel to ease your body’s reaction to the burn. Other home remedies may ease symptoms too.

Moderate or severe burns

More to severe burns likely require medical attention. Go to your nearest A&E immediately.

Pressure sores (ulcers)

Pressure sores – or ulcers – are a common issue in people with a spinal cord injury. Contact your healthcare provider and stay off the affected area. Your doctor may apply special bandages. In severe cases, medication or surgery may be required.

Minor cuts and lacerations

You or your carer should apply first aid to the area, cleaning the wound or scrape, applying an antibiotic and covering the area.

Other Causes

Broken bones

Go to A&E or see your doctor immediately.

Moderate or severe cuts or lacerations

Go to A&E or see your doctor immediately.

Fractures

Go to A&E or see your doctor immediately.

Sexual activity

Stop any sexual activity below the level of your injury that may be causing the spike in blood pressure. Check your blood pressure again. If this is a recurring issue, ask your doctor about medication or treatments that may help you continue sexual activity more safely.

Always err on the side of caution

Although we covered a lot of ground, this is not a complete list of all the potential autonomic dysreflexia triggers. Nevertheless, we have explored some of the most common and well-known stimuli. Other possible things happening below the level of your spinal cord injury can cause an overreaction from your autonomic nervous system. If your symptoms don’t resolve quickly, please go to A&E immediately.

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