Autonomic Dysreflexia

Question 1

Should a patient suspected to have experienced AD be transported if symptoms are relieved?

Answer 1

Yes. Investigation into probably cause and further in-hospital treatment are required to prevent cerebrovascular catastrophe.

Question 2

What are the 3 signs/symptoms that confirm autonomic dysreflexia?

Answer 2

Previous SCI at T6 or above
+ Severe headache
OR
+ SBP >160mmHg

Question 3

What is the STOP note in the AD guideline?

Answer 3

Identify and Rx possible causes - remove the stimulus

• If distended bladder, check IDC for kinks
• Mx pain, fractures, burns and labour

Question 4

If after attempting to Rx possible causes, and the BP remains ___________, what is the management of AD?

Answer 4

If BP >160mmHg then:
GTN 600mcg S/L or
GTN 300mcg S/L (no prev. admin)

Question 5

How often can GTN be administered in AD?

Repeat initial doses of GTN until…?

Answer 5

At 10 minute intervals.

Administer until symptoms resolve OR onset of side effects OR BP <160mmHg.