J - AUTONOMIC DYSREFLEXIA (AD)
Monitor for signs and symptoms of hyperthermia in individuals with SCI at or above T6 who are at risk for developing hyperthermia when exposed to a hot environment. (PVA-AD 2020, p.645; Level C)
Treat hyperthermia by decreasing the individual’s core temperature. This includes moving to a cooler environment (preferably an air-conditioned setting), drinking cool liquids, washing with tepid water, and resting. (PVA-AD 2020, p.645; Level C)
Provide education regarding measures to help prevent neurogenic hyperthermia. Preventative measures include wearing appropriate lightweight and light-coloured clothing, maintaining a proper temperature-controlled room (e.g., use of air-conditioning), frequently drinking cold fluids, maintaining appropriate hydration, and having a water spray and/or fan for exposed skin. This is especially important when in a hot environment. (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.659; Level C)
During exercise, individuals with SCI at T6 or above should be monitored for neurogenic hyperthermia. (PVA-AD 2020, Level C)