Autonomic Dysreflexia: Gaps in Awareness and Clinical Preparedness Among Healthcare Providers

Abstract

Background:  Autonomic dysreflexia (AD) is a potentially life-threatening emergency affecting patients with spinal cord injuries at or above T6 level. Despite its severity, healthcare provider knowledge regarding recognition and management remains understudied, particularly in developing healthcare systems.

Objective:  To assess awareness and clinical preparedness regarding autonomic dysreflexia among healthcare providers in tertiary care settings in Pakistan.

Materials and Methods:  This cross-sectional study utilized a structured questionnaire administered to 127 healthcare professionals (35 consultants, 92 residents) across three tertiary care hospitals in Rawalpindi and Islamabad, Pakistan. The survey assessed knowledge of AD pathophysiology, recognition, and management approaches. Data were analyzed using SPSS version 25.0.

Results:  The mean age of participants was 35.7 ± 7.4 years. Only 25.21% of respondents demonstrated adequate knowledge and preparedness for managing AD. Consultants showed significantly higher competency (48.15%) compared to residents (18.18%). Critical knowledge gaps were identified in first-line interventions, including proper patient positioning, identification and removal of noxious stimuli, and blood pressure management strategies.

Conclusion:  This study reveals substantial gaps in awareness and clinical preparedness regarding autonomic dysreflexia among healthcare providers in Pakistan. The findings highlight an urgent need for targeted educational interventions, particularly for residents who often serve as first responders in emergencies.