Diagnostic Division: Circulation

Definition: Life-threatening, uninhibited sympathetic response of the nervous system to a noxious stimulus after a spinal cord injury (SCI) at T7 or above.

RELATED FACTORS
Bladder/bowel distention; [Catheter insertion, obstruction, irrigation]; Skin irritation; Deficient patient/caregiver knowledge; [Sexual excitation, menstruation, pregnancy, labor/delivery]; [Environmental temperature extremes]

DEFINING CHARACTERISTICS

Subjective
Headache (a diffuse pain in different portions of the head and not confined to any nerve distribution area); Paresthesia; Chilling; Blurred vision; Chest pain; Metallic taste in mouth; Nasal congestion

Objective
Paroxysmal hypertension (sudden periodic elevated blood pressure in which systolic pressure >140 mm Hg and diastolic >90 mm Hg); Bradycardia or tachycardia (heart rate <60 or >100 beats per minute, respectively); Diaphoresis (above the injury); Red splotches on skin (above the injury); Pallor (below the injury); Horner’s syndrome [contraction of the pupil, partial ptosis of the eyelid, enophthalmos and sometimes loss of sweating over the affected side of the face]; Conjunctival congestion; Pilomotor reflex [gooseflesh formation when skin is cooled]