Author Wendy Ness is colorectal nurse specialist at Croydon University Hospital. Abstract


» The potentially harmful outcomes of developing AD;»



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The potentially harmful outcomes of developing AD;
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How to access staff able to undertake a manual evacuation. Ensure experienced staff are available to undertake and teach the procedure. Recognise that these patients are experts in managing their own bowel care.
Other bowel-emptying techniques
As suggested earlier, patients may rely on other mechanical ways of emptying their Autonomic dysreflexia (AD) occurs only in people with spinal cord injuries at or above the T level. It is related to disconnections between the body below the injury and the control mechanisms for blood pressure and heart function. It causes the blood pressure to rise to potentially dangerous levels. Common causes include:

Full bladder

Bladder infection

Severe constipation

Pressure ulcers

Anything that would normally cause pain or discomfort below the level of the spinal cord injury can trigger dysreflexia
Symptoms include a raised blood pressure resulting in:

Pounding headache

Spots before the eyes

Blurred vision
Other symptoms include:

Flushing of the skin

Sweating

Goosebumps

Some patients describe nasal stuffiness and will feel very anxious

Uncontrolled AD can cause a stroke if not treated
Treatment:

Remove the reason for the stimulation

Check for distended bladder/full bowel sit the patient up to decrease blood pressure

Administer prescribed medication to reduce blood pressure if necessary Seek medical advice
Adapted from www.spinal-injury.net/autonomic- dysreflexia.htm
Box 3.
AuTONOmIC DySReFlexIA
Box 2.
bOWel
DySFuNCTION
COmpeTeNCIeS

CC01 – Assess bladder and bowel dysfunction

CC08 – Care for individuals using containment products

CC09 – Enable individuals to effectively evacuate their bowels

CC12 – Enable individuals to undertake pelvic-floor muscle exercises

CC13 – Enable individuals with complex pelvic-floor dysfunction to undertake pelvic-floor muscle rehabilitation
Source: www.skillsforhealth.org.uk
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