View source for Disabled Village Children:Dysreflexia (Sudden High Blood Pressure with Pounding Headaches)

{{bctrail|segments=3|chaptitle=Chapter 23: Spinal Cord Injury}}
{{DISPLAYTITLE:Dysreflexia (Sudden High Blood Pressure with Pounding Headaches)}}
{{SideSupplement|bookabbreviation=dvc|pagealt=is from<br>pages 187 to 188 of|chapterpdf=http://hesperian.org/wp-content/uploads/pdf/en_dvc_2023/en_dvc_2023_23.pdf|bookurl=Disabled Village Children|booktitle=Disabled Village Children}}
{{chaptertoc|In this chapter:|
 <ul class{{=}}"noprint">
<li>[[Disabled Village Children:Chapter 23: Spinal Cord Injury|Chapter 23: Spinal Cord Injury]]</li>
    <li>[[Disabled Village Children:Early Questions That a Spinal Cord Injured Child and Family May Ask|Early Questions That a Spinal Cord Injured Child and Family May Ask]]</li>
    <li>[[Disabled Village Children:Helping the Child and Family Adjust|Helping the Child and Family Adjust]]</li>
    <li>[[Disabled Village Children:How to Prevent More Severe Spinal Cord Injury in Case of Accident|How to Prevent More Severe Spinal Cord Injury in Case of Accident]]</li>
   <li>[[Disabled Village Children:Early Care for the Spinal Cord Injured Person|Early Care for People with Spinal Cord Injuries]]</li>
    <li>[[Disabled Village Children:Physical Therapy Following Spinal Cord Injury|Rehabilitation Therapy Following Spinal Cord Injury]]</li>
<li>[[Disabled Village Children:Maintaining Healthy Positions|Maintaining Healthy Positions]]</li>
<li>[[Disabled Village Children:Early Physical Re-education|Early Physical Re-education]]</li>
    <li>[[Disabled Village Children:Dysreflexia (Sudden High Blood Pressure with Pounding Headaches)|Dysreflexia (Sudden High Blood Pressure with Pounding Headaches)]]</li>
 <li>[[Disabled Village Children:Self Care|Self Care]]</li>
    <li>[[Disabled Village Children:Keeping Active|Keeping Active]]</li>
    <li>[[Disabled Village Children:Other Parts of This Book with Information Useful For Spinal Cord Injury|Other Parts of This Book with Information Useful For Spinal Cord Injury]]</li>
<li>[[Disabled Village Children:The Story of Jésica|The Story of Jésica]]</li>
 </ul>
}}
Persons with quadriplegia or very high paraplegia run the risk of "dysreflexia"—or sudden, dangerous increase in blood pressure with severe pounding headaches.

Dysreflexia is the body’s reaction to something that would normally cause pain or irritation, but which the person does not feel because of the spinal cord injury.

=====COMMON CAUSES OF DYSREFLEXIA=====
*bladder problems—especially when the bladder is too full, infected, or has bladder stones (This is by far the most common cause.)
*stretching of the bowel—from constipation, with a big ball of hard shit, or from finger pressure to remove the shit
*pressure areas or sores—or even irritation from lying on a small object without knowing it
*burns
*spasm of the womb—especially just before or in the first days of a woman’s monthly period, or during childbirth

=====SIGNS (OF DYSREFLEXIA)=====
<div style="margin-right:225px">
[[Image:DVC_Ch23_Page_187-5.png|175px|right]]</div>
*severe pounding headache
*sweating of the head
*stuffy nose
*reddish skin patches on face and neck 
*goose pimples above the level of injury
*slow pulse
*high blood pressure (up to 240/150)
{{openbox|'''Dysreflexia is a medical emergency'''. The high blood pressure could cause seizures or deadly bleeding inside the brain.}}
====What to do====

'''Act quickly''' to remove the cause and lower the blood pressure.

<table>
<tr>
<td style{{=}}"text-indent: -15px; padding-left: 25px;">'''1.''' Quickly lower the blood pressure in the head.<br>
<div style="padding-left:30px;">&#9830;  If lying, sit up; stay sitting until the signs go away.<br></div>
<div style="padding-left:30px;">&#9830;  Change position, drop feet down, loosen belt or straps, remove tight stockings.</div></td></tr>

<tr>
<td style{{=}}"text-indent: -15px; padding-left: 25px;">'''2.''' Look for the cause of dysreflexia, and remove it if possible.
<div style="padding-left:30px;">&#9830;  Bladder. Feel the lower belly to see if the bladder is full. If a catheter is in place, check for bends or kinks and straighten them to let urine flow. If the catheter is stopped up, open it by injecting the catheter with 10 cc. sterile saline solution or water that has been boiled and cooled to body temperature. Or take the catheter out. If a catheter is not in place and the person cannot pee, put in a catheter and empty the bladder (see [[Disabled_Village_Children:How_to_Put_in_a_Catheter|"How to Put in a Catheter"]]).</div>
<div style="padding-left:30px;">&#9830; If a [[Disabled_Village_Children:Urinary_Infections|urinary infection]] appears to be the cause, inject an anesthetic solution into the bladder through a catheter. Use 10 cc. 1% lidocaine in 20 cc. of boiled water. Clamp the catheter for 20 minutes and then release. Treat the infection.</div>
<div style="padding-left:30px;">&#9830;  Bowel. If the bladder does not seem to be the cause, check for a full bowel. How long has it been since the last bowel movement (shit)? Put some lidocaine (''Xylocaine'') jelly on your finger and check if the bowel is packed with hard shit. If it is, wait 2 minutes for sensation in the area to decrease. Then put more lidocaine jelly on your finger and gently remove the shit. If the headache becomes worse while you're doing this, stop and put in more lidocaine jelly. Wait 20 minutes and try again to gently remove the shit with your finger. </div>
<div style="padding-left:30px;">&#9830;  Pressure. Change the child’s position in order to relieve pressure over bony areas. (Sometimes just staying in the same position too long can bring on dysreflexia.)</div></td></tr>

<tr>
<td style{{=}}"text-indent: -15px; padding-left: 25px;">'''3.''' If the signs do not go away, get medical help as fast as possible.</td></tr>

<tr>
<td style{{=}}"text-indent: -15px; padding-left: 25px;">'''4.''' If the child has frequent or severe periods of dysreflexia, or you cannot find the cause, try to have him seen by a specialist on spinal cord injury, and possibly a ‘urologist’ (specialist of the urine system).</td>
</tr>
</table>


{{openbox|'''Suggestion''': In villages where community members have quadriplegia,  it is wise to have injectable 1%&nbsp;lidocaine (Xylocaine) and lidocaine gel available for dysreflexia emergencies.}}





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