Autonomic dysreflexia
ICD-10 G90.4 is a billable code used to indicate a diagnosis of autonomic dysreflexia.
Autonomic dysreflexia is a potentially life-threatening condition that occurs in individuals with spinal cord injuries, particularly those with lesions above the T6 level. It is characterized by an exaggerated autonomic response to stimuli, often resulting in severe hypertension, bradycardia, and other autonomic disturbances. The condition is triggered by noxious stimuli below the level of the spinal injury, such as bladder distension, bowel impaction, or skin irritation. Patients may present with symptoms including severe headache, sweating, flushing, and anxiety. The pathophysiology involves a loss of descending inhibitory control from the brain, leading to unopposed sympathetic activation. Prompt recognition and management are crucial to prevent complications such as stroke or cardiac arrest. Treatment typically involves identifying and alleviating the triggering stimulus, along with pharmacological interventions to manage blood pressure and other symptoms. Understanding the triggers and symptoms of autonomic dysreflexia is essential for healthcare providers, especially in emergency settings, to ensure timely and effective care.
Detailed neurological assessment and history of spinal cord injury.
Patients presenting with severe hypertension and autonomic symptoms post-spinal cord injury.
Neurologists must document the level of injury and any interventions taken to manage dysreflexia.
Immediate assessment of vital signs and identification of potential triggers.
Emergency presentations of patients with known spinal cord injuries experiencing autonomic dysreflexia.
Emergency physicians should document the rapid assessment and management steps taken to mitigate risks.
Used when a patient with autonomic dysreflexia presents to the emergency department.
Document the severity of symptoms and interventions performed.
Emergency physicians should ensure thorough documentation of the patient's history and immediate management.
Common triggers include bladder distension, bowel impaction, skin irritation, and other noxious stimuli below the level of the spinal injury.
Management involves identifying and alleviating the triggering stimulus, monitoring vital signs, and administering antihypertensive medications if necessary.