You have just been dispatched to the home of a 40-year-old male,
who is complaining of a sudden onset of a severe headache,
blurred vision and diaphoresis. Upon arrival, you find the
patient lying on the couch. His initial blood pressure is
220/140 and his heart rate is 125 bpm. As you continue to assess
the patient, you notice a wheelchair in the corner. The patient
verifies that it is his chair, reporting that he suffered a
spinal cord injury approximately eight months ago. His level of
injury is T-6. How does this new information change your plan of
care? While his initial complaints may be a cardiac event, a
migraine headache or even a stroke, the pre-existing spinal cord
injury should refocus your areas of concern and initial care of
this patient. The patient may be experiencing the medical
emergency known as autonomic dysreflexia. Simple interventions
may easily correct some of his presenting symptoms and prevent
further injury to the patient. Autonomic dysreflexia is an
exaggerated response of the nerv