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Autonomic Dysreflexia
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Orthostatic Hypotension
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Spinal Cord Info 2
Precautions/Complications/OT interventions
| Precaution/Complication | Definition | OT Intervention |
|---|---|---|
| Autonomic Dysreflexia | ANS disorder, results in high BP. | Sit pt, make sure urinary catheter/ drainage bag are flowing, check 4 skin irritations, notify nursing staff |
| Orthostatic Hypotension | Pts usually immobilized in supine or prone & when 1st attempting to sit up, BP suddenly drops. | Recline. OT should collaborate on slow intro of moving from bed lying to sitting. |
| Respiratory Impairment | pt w/tetraplegia has respiratory difficulties. Those w/ tracheostomies often have difficulty coughing to clear respiratory passageways & will need suction @ various times. | Be alert for signs of need 4 suctioning. Either learn to perform suctioning or get appropriate personnel to do it. |
| Sensory Losses | sensory loss below lesion, high risk for decubiti. | Encourage vision use 2 compensate 4 loss. During trfs & bed mobility: avoid shearing stress or friction injuries 2 skin by lifting body away from surfaces. 4 WC/sittng: use cushions/weight shift every 15-20min. 4 bed: repositn evry 2hr, inspect skin daily |
| Hypo-Hyperthermia | SCI's w/orthostatic hypotension may have impaired thermal control. | Keep environment mild. Discont. ex if no A/C is avail. Be alert for signs of overheating or abnormal body temp. |
| Heterotopic Ossification | the presence of bone in soft tissue where bone normally does not exist. | Report to pts physician |
| Spinal Shock/Spasticity | Pts experience flaccid paralysis immediately post-SCI, may last up 2 a few months.Once reduced a pt w/ T12 or above may experience mild-mod spasticity. | Must (A) in spasticity mangmnt. Teach pt 2 use positioning & other techs to inhibit spasticity. Pt must also do regular ROM ex to prevent contractures. |
| Skin breakdown, Decubitus Ulcers | When sensory loss increases risk of skin breakdown. Pressure causes loss of blood supply to area=necrosis below skin surface. | Be aware of signs. Can be releived by eliminating pressure points/protecting vulnerable area from excessive shearing, moisture, heat. Routinely turn bed, use pressure relieving seat cushions or mattresses, protect bony prominences, perform weight shifts. |
| Osteoporosis | Due to disuse of long bones. Can cause pathological fractures. More common in LEs. | Implement a "standing program" while in rehab and upon D/C. |
| ROM Restrictions | Pts w/ PROM past 90 deg @ shoulder, nor should MMT or strengthening ex be provided. | Let wrist ext/fingr flexors be allowed to tighten to provide power for tenodesis. Never extend/flex wrist & digits @ same time. ROM ex 4 full flexion of digits only done w/wrist extended. 4 full finger ext wrist should be flexed. |
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