A nurse encountered a patient in a wheelchair 3 months after the patient had sustained a crushing injury to his cervical spinal cord at the level of C₆ in a motorcycle accident. Although the patient was paralyzed, his limbs were thrashing, his face was bright red, and he was sweating profusely. What was happening?

Question

Quizplus · Accepted Answer

The patient is experiencing a mass reflex, also known as autonomic dysreflexia, which is a potentially life-threatening condition that can occur after a spinal cord injury at or above the T6 level. The thrashing limbs, red face, and profuse sweating are symptoms of autonomic hyperactivity, caused by a reflex response to a noxious stimulus below the level of injury. In this case, it is likely that something is causing discomfort or pain for the patient, such as pressure on his skin, a full bladder or bowel, or a tight clothing item. It is important to identify and alleviate the cause of the reflexive response, as untreated autonomic dysreflexia can lead to complications such as stroke, seizures, or cardiac arrest.

A Nurse Encountered a Patient in a Wheelchair 3 Months