Orthostatic Hypotension and AD Flashcards
What is the most common timeframe for when patient’s experience autonomic dysreflexia
Within 1 year of injury
At what level of lesion can patients not regulate and maintain body temperature
T8 and above
What 2 complications are SCI patients with lesion above T8 at risk for?
Orthostatic hypotension
Autonomic dysreflexia
Mechanism of orthostatic hypotension in SCI patients
Aortic and carotid baroreceptors sense a decrease in BP, however sympathetic efferent pathways are interrupted in SCI and brainstem is unable to send message to increase BP = hypotension
How much of an increase in BP occurs in autonomic dysreflexia?
20-40 mmHg above reference range
3 main pharmacologic treatments for autonomic dysreflexia
- Nitropaste
- Clonidine
- Nifedipine
What level of SCI do you have impaired vs absent sympathetic innervation to the heart
≥T6 lesions = impaired
≥ T1 lesions = absent
First aspect of treatment in autonomic dysreflexia
Sit the patient upright
What 2 oral medications can be used for orthostatic hypotension
Midodrine (alpha-1 agonist)
Florinef (mineralocorticoid)
What do vital signs show if someone is in autonomic dysreflexia
HTN and bradycardia
At what point do you administer medications for autonomic dysreflexia
If BP > 150
How do you prevent autonomic dysreflexia during labor?
Spinal anesthesia
How long after injury can patients experience autonomic dysreflexia?
2-4 weeks post-injury