J - AUTONOMIC DYSREFLEXIA (AD)
Monitor for signs and symptoms in individuals with SCI at T6 or above who are at risk for developing hypothermia when exposed to a cold environment. (PVA-AD 2020, p.644; Level C)
If possible, obtain a rectal temperature when evaluating an individual for hypothermia because skin temperate is not accurate for monitoring core body temperature. Oral and tympanic are also acceptable methods of temperature monitoring. (PVA-AD 2020, p.644; Level C)
Use ambient temperature regulation, insulated clothing, blankets, warm humidified air, and intake of warm fluid into the gastrointestinal tract to help prevent and manage hypothermia. Heating devices should be used with extreme caution in insensate areas. (PVA-AD 2020, p.645; Level C)
In cold ambient environments, instruct individuals to consider avoiding alcohol intake, as it causes vasodilation and heat loss. (PVA-AD 2020, p.645; Level C)
Be aware of and discuss with individuals with SCI that certain medications or substances may disrupt temperature regulation (hypo- or hyperthermia), including alpha-agonists (e.g., tizanidine, clonidine), narcotics, oxybutynin, gabapentin, and antidepressants that are norepinephrine and serotonin reuptake inhibitors. (PVA-AD 2020, p.645; Level C)