Autonomic Dysreflexia
Spinal Cord Injury with Complication of Autonomic Dysreflexia
Ashley Audette, Shelby LeBel, and Jocelyn Neufeld
Nurs 361 Nursing of Adults
Sandra Fritz and JoDee Wentzel
March 14, 2014
Autonomic dysreflexia is a complication of spinal cord injuries. “It is a massive, uncompensated cardiovascular reaction mediated by the sympathetic nervous system” (Lewis, 2014, p.1784). There are many factors that need to be explored in relation to the complication of autonomic dysreflexia in spinal cord injuries. These factors include etiology, pathophysiology, clinical manifestations, diagnostics, and collaborative care.
Lewis (2014) states “ spinal cord injuries are generally the direct result of trauma that causes cord compression, ischemia, edema, and possible cord transection”(p.1172). The level and degree of injury have a direct relation to the severity of symptoms, with the higher the injury, the more loss of function you have because of the close proximity to the brain stem, medulla, and cervical cord (Lewis, 2014). There are five major mechanisms of injury including hyperextension, flexion, flexion-rotation, extension-rotation, and compression (Lewis, 2014). Complete injury means there is no sensory or motor function below the level of injury. Incomplete injury is a mixed loss of motor and sensory function below the level of injury. The degree varies between sensory and motor loss due to the level of injury (Lewis, 2014). There are three levels of injury, those being cervical, thoracic, and lumbar. Lumbar and cervical injuries are the most common due to movement and increased flexibility (Lewis, 2014). Depending on the degree of injury you may become a paraplegic or a tetraplegia. Paraplegia is a loss of sensation in the trunk and lower limbs due to the thoracic cord in the lumbar spine being damaged (Lewis, 2014). Tetraplegia is paralysis in all four extremities due to the cervical cord being
Ashley Audette, Shelby LeBel, and Jocelyn Neufeld
Nurs 361 Nursing of Adults
Sandra Fritz and JoDee Wentzel
March 14, 2014
Autonomic dysreflexia is a complication of spinal cord injuries. “It is a massive, uncompensated cardiovascular reaction mediated by the sympathetic nervous system” (Lewis, 2014, p.1784). There are many factors that need to be explored in relation to the complication of autonomic dysreflexia in spinal cord injuries. These factors include etiology, pathophysiology, clinical manifestations, diagnostics, and collaborative care.
Lewis (2014) states “ spinal cord injuries are generally the direct result of trauma that causes cord compression, ischemia, edema, and possible cord transection”(p.1172). The level and degree of injury have a direct relation to the severity of symptoms, with the higher the injury, the more loss of function you have because of the close proximity to the brain stem, medulla, and cervical cord (Lewis, 2014). There are five major mechanisms of injury including hyperextension, flexion, flexion-rotation, extension-rotation, and compression (Lewis, 2014). Complete injury means there is no sensory or motor function below the level of injury. Incomplete injury is a mixed loss of motor and sensory function below the level of injury. The degree varies between sensory and motor loss due to the level of injury (Lewis, 2014). There are three levels of injury, those being cervical, thoracic, and lumbar. Lumbar and cervical injuries are the most common due to movement and increased flexibility (Lewis, 2014). Depending on the degree of injury you may become a paraplegic or a tetraplegia. Paraplegia is a loss of sensation in the trunk and lower limbs due to the thoracic cord in the lumbar spine being damaged (Lewis, 2014). Tetraplegia is paralysis in all four extremities due to the cervical cord being
References: Lewis, S.L., Heitkemper, M.M., Dirksen, S. R., Bucher, L., & Camera, I.M. (2014). Medical-surgical nursing in Canada: Assessment and management of clinical problems. Toronto: Mosby Canada. Gutierrez, K., Nutz, P.A., & Albanese, J.A. (2014). Mosby’s Nursing Drug Cards. Toronto: Mosby Canada. Tipton, K. (1998). Action stat: autonomic dysreflexia. Nursing, 28(11), 33. Krassioukov, A., Karlsson, A., Wecht, J., Wuermser, L., Mathias, C., & Marino, R. (2007). Assessment of autonomic dysfunction following spinal cord injury: rationale for additions to International Standards for Neurological Assessment. Journal Of Rehabilitation Research & Development, 44(1), 103-112. Dunn, K. (2004). Identification and management of autonomic dysreflexia in the emergency department. Topics In Emergency Medicine, 26(3), 254-259. Blackmer, J. (2003). Rehabilitation medicine: 1. Autonomic dysreflexia. CMAJ: Canadian Medical Association Journal, 169(9), 931-935. Milligan, J., Lee, J., McMillan, C., & Klassen, H. (2012). Autonomic dysreflexia: Recognizing a common serious condition in patients with spinal cord injury. Canadian Family Physician, 58(8), 831-835.