🩻 Chapter 751 · Spinal Cord Injury & Autonomic Dysreflexia Management

Nelson Textbook of Pediatrics 22nd Edition | Pediatric SCI: SCIWORA, cervical/upper thoracic lesions → autonomic dysreflexia (AD) risk. ASIA Impairment Scale, bowel/bladder programs, DVT prophylaxis, spasticity, hypercalcemia, outcomes by neurologic level.

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📋 30 Clinical Scenarios — Pediatric SCI & Autonomic Dysreflexia

📇 High‑Yield Review Cards

🩺 Clinical Recognition: SCI & Autonomic Dysreflexia

Select a pediatric SCI presentation for diagnostic approach and emergency management (Nelson Ch 751).

📋 Stepwise Management of Spinal Cord Injury & AD

🔑 Key Principles — Chapter 751
• Autonomic Dysreflexia (AD): Sustained sympathetic response to noxious stimulus below injury level (T6 or above). Symptoms: hypertension, bradycardia, headache, flushing above injury. Emergent: sit upright, identify/remove stimulus (bladder/ bowel distention), if BP persists → nifedipine or nitropaste.
• SCIWORA: Spinal cord injury without radiographic abnormality — common in children, delayed deficits up to 4 days.
• ASIA Impairment Scale: A (complete), B (sensory incomplete), C/D motor incomplete, E normal. Prognosis based on level and completeness.
• Bladder management: Clean intermittent catheterization (CIC) 4-6x/day, anticholinergics for storage.
• DVT prophylaxis: Mechanical for all acute SCI; adolescents add anticoagulant.

    ⚡ Reflex Prompts — SCI & AD Emergencies

    📖 Summary: Spinal Cord Injury & Autonomic Dysreflexia (Nelson 751)