In an outpatient transfer for a T3 AIS A SCI, a severe headache and facial sweating occur with high blood pressure that does not resolve after basic measures. What is the MOST appropriate next step?

In an outpatient transfer for a T3 AIS A SCI, a severe headache and facial sweating occur with high blood pressure that does not resolve after basic measures. What is the MOST appropriate next step?

• A. Have the patient perform a pressure relief and recheck in 15 minutes
• B. Call 911, as this is a life-threatening emergency that is not resolving
• C. Place the patient prone to reduce blood pressure
• D. Apply ice packs to the forehead and recheck blood pressure in 5 minutes

Answer: (B)

Autonomic dysreflexia can occur in people with SCI at or above T6, where a noxious stimulus below the injury triggers a sudden, dangerous rise in blood pressure accompanied by a severe headache and sweating. This is a medical emergency because the blood pressure surge can lead to stroke, seizures, or organ damage if not treated promptly. If basic measures to lower BP don’t resolve the hypertension, the next step is to call emergency services immediately for urgent evaluation and treatment. While awaiting help, keep the patient upright to aid BP reduction, check for common triggers (such as a kinked catheter, full bladder, stool impaction, or restrictive clothing) and remove them if found, and monitor vital signs. Avoid placing the patient prone or using ice packs as a sole intervention, since they do not address the underlying crisis.

Autonomic dysreflexia can occur in people with SCI at or above T6, where a noxious stimulus below the injury triggers a sudden, dangerous rise in blood pressure accompanied by a severe headache and sweating. This is a medical emergency because the blood pressure surge can lead to stroke, seizures, or organ damage if not treated promptly. If basic measures to lower BP don’t resolve the hypertension, the next step is to call emergency services immediately for urgent evaluation and treatment. While awaiting help, keep the patient upright to aid BP reduction, check for common triggers (such as a kinked catheter, full bladder, stool impaction, or restrictive clothing) and remove them if found, and monitor vital signs. Avoid placing the patient prone or using ice packs as a sole intervention, since they do not address the underlying crisis.