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IP - Sub-Acute Spinal Cord Injury - Adult - Supplemental [6189]

IP - Sub-Acute Spinal Cord Injury - Adult - Supplemental [6189] - Clinical Hub, UW Health Clinical Tool Search, UW Health Clinical Tool Search, Order Sets, Inpatient, Neurosciences

IP - Sub-acute Spinal Cord Injury - Adult - Supplemental [6189]
for Adult Patients OnlyIntended
Autonomic Dysreflexia [206778]
nitroglycerin (NITRO-BID) 2 % ointment [40285] 1 inch, Transdermal, PRN For 2 Doses, Autonomic
Administer 1 inch every 15 minutes for 2 doses for
increase SBP>30 or DBP >20 above baseline for
autonomic dysreflexia. Notify prescriber if
hypertension and/or signs and symptoms are not
resolved after second dose. Remove paste after
resolution of symptoms.
Symptoms / Treatment for Autonomic Dysreflexia
Symptoms of Autonomic Dysreflexia
- Complaint of rapid onset of headache
- Change in blood pressure of 20-40 mmHg above
patient's normal baseline
- Bradycardia
- Flushing
- Goosebumps or perspiration above level of injury
- Complaint of nasal congestion
Treatment Strategies for Autonomic Dysreflexia
- Check blood pressure every 5-10 minutes until
resolved (sit patient at 90 degrees with legs lowered).
- Check for over distended bladder. Check Foley
catheter for kinks. If needed, catheterize patient
using lidocaine jelly.
- Check for rectal impaction. If needed, remove stool
gently using lidocaine jelly.
- Loosen tight clothing. Look for skin being pinched If
a source cannot be located.
- Apply Nitropaste as ordered (if none of above
strategies have treated symptoms).
Spasticity [206779]
baclofen (LIORESAL) tab [720020] 5 mg, Oral, EVERY 8 HOURS
Hypotension [206634]
midodrine (PROAMITINE) tab [45758] 5 mg, Oral, 3 X DAILY (AT MEALTIME)
Hold for SBP/DBP > ***/***.
Pain [206780]
oxycodone tab [45976] 5-10 mg, Oral, EVERY 3 HOURS PRN, pain, Severe
gabapentin (NEURONTIN) cap [54258] 300 mg, Oral, 3 X DAILY
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Printed by O'BRIEN, RYLEY P [RPO249] at 9/29/2016 3:01:12 PM
Copyright © 201� University of Wisconsin Hospitals and Clinics Authority
Contact: Lee Vermeulen, CCKM@uwhealth.org Last Revised: 10/2016CCKM@uwhealth.org