Question 1

What is autonomic dysreflexia?

Accepted Answer

It is a sudden, potentially life-threatening rise in blood pressure in someone with a spinal cord injury at or above T6. A noxious stimulus below the lesion, most often a full or blocked bladder, triggers widespread vasoconstriction that the brain cannot correct across the injury.

Question 2

What should I do first if an athlete develops autonomic dysreflexia?

Accepted Answer

Sit them upright and lower the legs, loosen anything tight, and find and remove the trigger, checking the bladder first. Measure blood pressure every 1 to 2 minutes until stable, and consider a short-acting antihypertensive if the systolic pressure is 150 mmHg or above.

Question 3

Why can a normal-looking blood pressure be dangerous after spinal cord injury?

Accepted Answer

Resting blood pressure in tetraplegia is often low. A rise of more than 20 mmHg above the person's usual baseline defines dysreflexia, so a reading that looks normal can be a dangerous rise, which is why the baseline is recorded in advance.

Question 4

What is boosting, and how is it policed?

Accepted Answer

Boosting is deliberately triggering autonomic dysreflexia to improve performance. The IPC prohibits it: an athlete whose systolic pressure is above 160 mmHg on a re-check about 10 minutes later is withdrawn, and a deliberate attempt leads to disqualification whatever the blood pressure.

Spinal Cord Injury and Autonomic Dysreflexia

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