Autonomic Dysreflexia (Adult)

Status
Suspected autonomic dysreflexia
Confirms Autonomic Dysreflexia
Previous spinal cord injury at T6 or above - Severe headache - Systolic BP >160
Identify & treat possible causes - remove the stimulus
If distended bladder (common), ensure indwelling catheter is not kinked
Manage pain, e.g. fractures, burns, labour

Previous Nitrates   No Previous Nitrates GTN 600mcg S/L/Buccal   GTN 300mcg S/L/Buccal           Assess response to Mx

Adequate response Transport to nearest appropriate hospital

Inadequate response - BP remains >160 Repeat initial dose of GTN, 10 minutely until either: - Symptoms resolve - Onset of side effects - BP <160 Transport to nearest appropriate hospital

Special Notes

Transport the Pt even if the symptoms are relieved as this presentation meets the criteria of Autonomic Dysreflexia, a medical emergency that requires identification of probable cause and treatment in hospital to prevent cerebrovascular catastrophe.