Medical Emergencies

 What are medical emergencies?
 What is Autonomic Dysreflxia?
How will I know that I have autonomic dysreflexia?
What are the main causes for autonomic dysreflxia?
What is the immediate action to be taken?
What are the other emergencies that can arise?
Tell me more about Chest infections
What is Decreased Lung Volume?
How can I prevent this?
What is assisted coughing?
Why Congestion and/or Pneumonia happen?
How can I prevent it in the first place?
How can low Stood Pressure be an emergency?
What are the symptoms of low blood pressure?
What immediate action I need to take if I feel like that?
 

Medical Emergencies are a few conditions affecting spinal cord injured people that, require urgent treatment. They can happen anytime irrespective of the numbers of years that have passed after your injury. You should be aware of them and the first aid that is required just incase you are faced with them at home. They are as follows

• Autonomic Dysreflexia
• Pressure sore
• Bladder blockage or infection
• Kidney infection
• Chest infection
• Sudden lowering of Blood Pressure

This is a warning system to let you know that something is wrong; and that your body is experiencing pain or discomfort. This is an acute emergency and if not treated quickly may lead to bleeding in the brain with serious consequences. It consists of a rapid increase in blood pressure caused by pain, irritation or over-stimulation in a paralyzed part of the body. Only if you have a spinal cord lesion above T6 are you prone to autonomic dysreflexia or hyper-reflexia. Your family members should also be aware of Autonomic Dysreflexia so that they can help you when needed.

The Symptoms for autonomic dysreflexia are

• Pounding headache
• Goose pimples
• Profuse sweating
• Flushed and blotched skin on face and upper trunk Those with a spinal cord lesion above T6 must be aware of autonomic dysreflexia or hyper-reflexia and so should their family and carers.
• High blood pressure

Note: You may already have a lower normal blood pressure (e.g. 90/160) after injury, therefore 120/180 may represent a rise.

The symptoms of autonomic dysreflexia can be any one of the following or combination of the follows over-full bladder caused by a blocked catheter bladder stones. Urinary tract infection constipation anal fissure wind ingrown toenail burns or scalds pressure sore labor pain ejaculation during sexual intercourse menstrual cramps

• Remove the cause (if possible) you may have to contact your doctor to help you remove the cause.
• Sit up either yourself or with help
• If symptoms persist, give drugs to lower the blood pressure and contact your doctor
• Autonomic Dysreflexia is a serious condition and if immediate relief is not achieved you must call a doctor.

Other emergencies that can arise are Pressure sores and problems related to the Bladder like Kidney infection and kidney stones. These are discussed at length in chapters given before. Apart from these you may be prone to Chest infections and low blood pressure.

If your spinal lesion is above T6 you have to, take extra care to avoid chest infections The potential problems that may occur in the are

• Decreased Lung Volume
• Congestion and/or Pneumonia

Decreased lung volume is caused be either change in the function of the respiratory muscles or thick secretions in the lungs. You can identify this by shortness of breath.

Decreased lung volume can be prevented by regularly

• Doing deep breathing regularly
• Sitting in wheelchair daily
• Maintaining regular turning schedule in bed
• Doing regular assisted coughing as needed to bring up secretions
• Do respiratory treatment as prescribed by the doctor

Assisted coughing is when someone else assists you in coughing out your secretions which you may be unable to do yourself. Coughing assists in cleaning thickened secretions from the respiratory system. If your spinal lesion is T6 and above then ask your physiotherapist to teach assisted coughing procedure to your family members, who can assist you at home.

They occur when there is thickened secretions in the lungs that is not being coughed up and out. The symptoms of them are

• Decreased lung volume
• Excess secretion in the lungs
• Heavy feeling in the chest
• Elevated temperature (above normal)

• Drink 2 to 3 litres of water daily
• Do daily deep breathing exercising
• Sit in wheelchair daily
• Maintain regular turning schedule in bed
• Stop smoking in case you do

Low blood pressure in the range of 90/60 is quite a common feature after Spinal Cord Injury, specifically if you have a cervical lesion. But at times such as after bowel movement the BP start lowering down and should be checked.

Most common symptoms are 

• Feeling sleepy
• Blurring of speech
• Feeling very hungry

You just need to eat something preferably salty and rest. If it still persists then contact your doctor.