Autonomic Dysreflexia:

For individuals who are paralyzed Autonomic Dysreflexia can occur when a stimulus happens to the body below the level of injury. This can be a pain or irritant (such as tight clothing or something pinching the skin) or a normal function that the body may not notice (such as having a full bladder and needing to urinate).Temperature can be of special concern given the fact that the person has no idea temperature extreme is occurring and that the temperature of the environment does not have to be extreme to cause Autonomic Dysreflexia. Poor hydration is another possible cause. Don't wait to hydrate. These situations trigger an automatic reaction that causes the blood pressure to go up. As the blood pressure goes up, the heartbeat slows and may become irregular. The body cannot restore its blood pressure to normal because of the spinal cord damage. The only way to return things to normal is to alleviate the situation that is causing the problem and that cause is not always identifiable.


Be prepared to call 911, or other emergency services, if you or the person with the spinal cord injury (SCI) has the symptoms of Autonomic Dysreflexia. You or a caregiver must realize how difficult it can be to treat it because the cause can be so hard to identify. If not treated promptly and correctly it can quickly lead to seizures, stroke, and even death.


Many medical professionals and institutions have no idea what Autonomic Dysreflexia is, the symptoms, how to treat it or worse yet that it is a life threatening emergency. This is why it is critical for you to have complete knowledge about AD, so you can self advocate, and have an Emergency Information Sheet or wallet card with you all the times in case you are incapacitated. Be sure it includes a phone number and website where information can be attained immediately. Twice I've been in hospital emergency rooms where neither the doctors nor nurses had any idea what Autonomic Dysreflexia was or its potential.

Some of the Causes


Vasodilation Above Level of Injury:

A pounding headache.

A flushed face and/or red blotches on the skin above the level of spinal injury.

Sweating above the level of spinal injury.

Nasal stuffiness.


A slow heart rate (bradycardia).

Vasoconstriction Below Leel of Injury:

Goose bumps below the level of spinal injury.

Cold, clammy skin below the level of spinal injury.

Pale coloring



*Sit up straight, or raise your head so you are looking straight ahead. If you can lower your legs, do so. You need to be sitting upright until your blood pressure is back to normal.

*Loosen or take off any tight clothing or accessories. This includes braces, catheter tape, socks or stockings, shoes, and bandages.

*Empty your bladder by draining your Foley catheter or using your catheter.

*Use digital stimulation, if necessary, to empty your bowel.

*Check your skin for red spots that mean you might have a pressure sore.

*If possible, check your blood pressure every 5 minutes to see if it improves.


Contact emergency personnel even if symptoms correct themselves.

For more information see Handi-Pill

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