Autonomic Dysreflexia

Question 1

Above which point of the spine does an injury need to be to cause autonomic dysreflexia?

Answer 1

T6

Question 2

How should we manage a patient with a T4 injury, displaying signs of a stroke but also acutely hypertensive?

Answer 2

Withhold GTN as it may worsen the penumbra and manage as stroke

Question 3

How can we minimise stimuli in an Autonomic Dysreflexia?

Answer 3

Posture upright
Loosen tight clothing
Inspect catheter for kinks
Manage pain

Question 4

Management of Autonomic Dysreflexia if hypertension persists after minimising stimuli?

Answer 4

SL GTN 300mcg every 5 mins
OR
GTN infusion 5mcg/min titrate to effect