Autonomic Dysreflexia: What Level of Knowledge in Portuguese Emergency Rooms?

• Autor(a) principal: Bettencourt, Mónica; Centro de Medicina e Reabilitação de Alcoitão
• Data de Publicação: 2016
• Outros Autores: Carvalho, Maria da Paz; Centro de Medicina e Reabilitação de Alcoitão, Faria, Filipa; Centro de Medicina e Reabilitação de Alcoitão
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.25759/spmfr.212
• topic: Autonomic Dysreflexia; Clinical Competence; Emergencies; Emergency Service, Hospital; Health Knowledge, Attitudes, Practice; Competência Clínica; Conhecimentos, Atitudes e Prática em Saúde; Disreflexia Autonómica; Emergências; Serviço de Urgência Hospitalar

Introduction: Autonomic dysreflexia is a complication after spinal cord injury and occurs in spinal injuries at or above T6. Due to its unexpected beginning and paroxistic hypertension, patients often go to the Emergency Room , where health professionals have limited experience/contact on treating this condition. This can result in a delay in diagnosis and appropriate treatment resulting in potentially serious complications, such as stroke, seizures and even death.The study goal was to determine the level of knowledge about autonomic dysreflexia of a convenience sample of physicians working at an Emergency Room in Portuguese Hospitals and to suggest measures to improve their knowledge about this syndrome.Material and Methods: We created an anonymous online multiple choice questionnaire with seven questions about autonomic dysreflexia and their treatment in the Emergency Room for physicians of Internal Medicine working in Portuguese Hospitals.Results: We obtained 41 responses. Of these, 31 of the doctors knew what autonomic dysreflexia is, however only 9 had observed a patient with this syndrome. Eleven knew the value of the normal systolic pressure in tetraplegic patients, but 8 did not know the symptoms of autonomic dysreflexia and 10 did not know how to treat a patient with this condition. When we asked about their level of knowledge about autonomic dysreflexia and its treatment, thirty of respondents assumed that this was “insufficient” and 8 said that “they didn`t know anything about this.” For the majority (33) it would be “very useful” that these patients carried an informative card about autonomic dysreflexia when they came to Emergency Room.Conclusions: It is vital to recognize this clinical syndrome that can lead to death, and with proper and timely treatment reduces possible complications. Since this is a rare situation, knowledge of medical staff of the Emergency Room of our hospitals may not be sufficient in this area. Thus, the Physical Medicine and Rehabilitation plays an important role in providing further teaching initiatives and information about autonomic dysreflexia.