A retrospective review of safety using a nursing driven protocol for autonomic dysreflexia in patients with spinal cord injuries

The Journal of Spinal Cord Medicine
Ryan SolinskyAaron E Bunnell

Abstract

Autonomic dysreflexia is a potentially life-threatening condition which afflicts a significant proportion of individuals with spinal cord injuries (SCI). To date, the safety and efficacy of several commonly used interventions for this condition have not been studied. A retrospective chart review of the safety of a previously implemented nursing driven inpatient autonomic dysreflexia protocol. Seventy-eight male patients with SCI who experienced autonomic dysreflexia while inpatient at our Veterans Affairs SCI unit over a 3-1/2-year period were included. The safety of a nursing driven protocol utilizing conservative measures, nitroglycerin paste, and oral hydralazine was evaluated. Occurrence of adverse events and relative hypotensive events during all episodes treated with the protocol, and efficacy of attaining target blood pressure for all episodes with protocol adherence and for initial episode experienced by each patient. Four hundred forty-five episodes of autonomic dysreflexia were recorded in the study period, with 92% adherence to the protocol. When the protocol was followed, target blood pressure was achieved for 97.6% of all episodes. Twenty-three total adverse events occurred (5.2% of all episodes). All adverse event...Continue Reading

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Citations

Mar 23, 2017·The Journal of Spinal Cord Medicine·Florian P ThomasStephen Cavanaugh
Aug 23, 2018·The Journal of Spinal Cord Medicine·Florian P Thomas, Carolann Murphy
Aug 9, 2017·The Journal of Spinal Cord Medicine·Ryan SolinskyStephen P Burns
Sep 11, 2018·The Journal of Spinal Cord Medicine·Ryan Solinsky, Todd A Linsenmeyer
Nov 19, 2019·Neurourology and Urodynamics·Ryan SolinskyTodd A Linsenmeyer

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