Alarming blood pressure changes during routine bladder emptying in a woman with cervical spinal cord injury

Spinal Cord Series and Cases, 2017 · DOI: 10.1038/s41394-017-0022-y · Published: October 10, 2017

Simple Explanation

Autonomic dysreflexia (AD) is a dangerous condition for people with high-level spinal cord injuries. It causes sudden, large increases in blood pressure. AD can be triggered by things like a full bladder. This case shows how a common bladder emptying method, the Credé maneuver, can cause AD. The Credé maneuver, applying pressure to the lower abdomen to help void the bladder, should be avoided in SCI patients due to the risk of inducing AD and dangerously high blood pressure.

Study Duration

Not specified

Participants

A 58-year-old woman with C3 AIS B SCI

Evidence Level

Level 4, Case Report

Key Findings

1
The Credé maneuver can induce a rapid and significant increase in systolic blood pressure in individuals with cervical SCI.
2
Episodes of AD triggered by the Credé maneuver can be associated with cardiac arrhythmias, such as premature ventricular contractions (PVCs).
3
The ISAFSCI table effectively collected crucial information related to the severity of Ms. X’s AD.

Research Summary

This case report describes a 58-year-old woman with C3 AIS B SCI who experienced severe autonomic dysreflexia (AD) during bladder emptying using the Credé maneuver. The Credé maneuver, involving manual pressure on the abdomen, led to a rapid spike in systolic blood pressure, reaching up to 230 mmHg, accompanied by a headache, flushing, and premature ventricular contractions (PVCs). The case highlights the risk of inducing AD with the Credé maneuver and emphasizes the importance of selecting optimal bladder management protocols for individuals with SCI.

Practical Implications

Bladder Management Protocol

Careful selection of bladder management protocols is crucial to minimize the risk of triggering AD in individuals with SCI.

Avoidance of Credé Maneuver

The Credé maneuver should be avoided in individuals with cervical SCI due to the risk of inducing severe AD and potential cardiovascular complications.

Clinical Monitoring

Close monitoring of blood pressure and cardiovascular function is essential during bladder management in individuals with SCI, especially those with cervical or high-thoracic injuries.

Alarming blood pressure changes during routine bladder emptying in a woman with cervical spinal cord injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Bladder Management Protocol

Avoidance of Credé Maneuver

Clinical Monitoring

Study Limitations

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Alarming blood pressure changes during routine bladder emptying in a woman with cervical spinal cord injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Bladder Management Protocol

Avoidance of Credé Maneuver

Clinical Monitoring

Study Limitations

Your Feedback

Was this summary helpful?