AUTONOMIC DYSREFLEXIA-MANAGEMENT

SUMMARY

1. Ensure catheter is not kinked or blocked.

2. Check bladder volume.

3. Sit patient up and loosen clothing with legs dangling over the bedside.

4. Check for faecal impaction.

5. If SBP > 150mmHg, use GTN, calcium channel blockers. Nifedipine should be used with caution in elderly patients. Other agents: hydralazine, ARB is useful in recurrent AD.

6. Remember that after an episode has resolved, close monitoring is recommended as repeated episodes are more likely to occur over the next 24-48 hours, even with stimuli that do not usually trigger AD (e.g. muscle stretching).

7. Patients need good bladder, bowel, skin and toe care. Caregiver training is essential to prevent recurrence.

Reference(s)

Cifu, D.X. (2020). Braddom’s physical medicine and rehabilitation. Elsevier. Get it on Amazon.
Cuccurullo, S. (2019). Physical medicine and rehabilitation board review. New York: Demosmedical. Get it on Amazon.
O’Young, B., Young, M.A. and Stiens, S.A. (2008). Physical Medicine and Rehabilitation Secrets. Mosby. Get it on Amazon.