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188 chapter 23
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.
• Quickly lower the blood pressure in the head.
• If lying, sit up; stay sitting until the signs go away.
• Change position, drop feet down, loosen belt or straps, remove tight stockings.
• Look for the cause of dysreflexia, and remove it if possible.
• 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 30 cc. of boiled and cooled
water (or sterile saline solution) into the catheter. 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 p. 206).
• If a 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
(see p. 210).
• 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, put in more lidocaine jelly. Wait 15 minutes, or until the
headache becomes less. Then gently remove the shit with your finger.
• 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.)
• If the signs do not go away, get medical help as fast as possible.
• 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).
Suggestion: For quadriplegics in villages, it is
wise to have injectable 1% lidocaine (Xylocaine) and
lidocaine gel available for dysreflexia emergencies.
Disabled village Children
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