Advice Needed: Helping Nurses Recognize a Dangerous but Obscure Condition - page 2

What is the best way for a patient to alert you to and educate you about autonomic dysreflexia (AD), an emergent, potentially life-threatening medical condition most doctors and nurses have never... Read More

  1. by   cherrybreeze
    Quote from linearthinker
    I don't know any physician or nurse who doensn't know what autonomic dysreflexia is. How strange.

    I was going to say something similar to this, I have known since nursing school with AD is, and how it can present. I was surprised to read in your OP that "most doctors and nurses" have never heard of it. I wouldn't have thought that?
  2. by   handyrn
    In your situation, since it is a small hospital that you go to, I would definitely ask your Dr. or someone on the hospital staff if they could do an inservice on it for all the hospital employees.

    I had a good friend who was a quad. Her Catheter fell out which threw her into AD and she went to the ER. Her friend that took her there was in the waiting room. The staff there also did not know the severity of what was happening and left her laying in a bed even though she told them what was going on and if they would just cath her it would fix the problem. They didn't believe her. She ended up yelling until her friend heard her and came into the room and cathed her himself with a straw or pen tube or something.

    Dr. finally arrives and boy did the ER staff get in trouble I guess. He was an older doc and this was before the days of Web MD and people were not self diagnosing so much. He told the staff that they really needed to listen to their patients and give them credit for what they knew was going on with their own bodies.

    Anyway, I just basically agree that education is the key.
  3. by   LegzRN
    Your forum name is awesome.
  4. by   Anna Flaxis
    Quote from cherrybreeze
    I was going to say something similar to this, I have known since nursing school with AD is, and how it can present. I was surprised to read in your OP that "most doctors and nurses" have never heard of it. I wouldn't have thought that?
    Exactly. I learned about AD in nursing school, as it is a standard part of the curriculum. I can know all about your condition, but if I don't have a bed to put you in, you're going to have to wait until someone else gets discharged or transferred up to the floor to be roomed. In the meantime, I'll be watching you like a hawk.
  5. by   Anna Flaxis
    Quote from handyrn
    I had a good friend who was a quad. Her Catheter fell out which threw her into AD and she went to the ER. Her friend that took her there was in the waiting room. The staff there also did not know the severity of what was happening and left her laying in a bed even though she told them what was going on and if they would just cath her it would fix the problem. They didn't believe her. She ended up yelling until her friend heard her and came into the room and cathed her himself with a straw or pen tube or something.
    What were her VS?
    What are the protocols in that ER for what nurses may and may not do prior to an examination by the MD?
    Did they actually say "I don't believe you"?
    Sounds like she was put in a bed right away, but the nurses had to wait for a doctor's order to be able to cath the patient. Some doctors will not give such an order if they haven't laid eyes on the patient, so the patient will have to wait until seen by an MD for anything to happen. Just because you're in the emergency room does not mean everything is going to happen immediately (excepting resuscitation, trauma, cath alert, stroke alert, etc). There are processes and procedures there just as there are in any medical setting.

    Dr. finally arrives and boy did the ER staff get in trouble I guess. He was an older doc and this was before the days of Web MD and people were not self diagnosing so much. He told the staff that they really needed to listen to their patients and give them credit for what they knew was going on with their own bodies.
    This sounds like a terrible doctor to work with.
  6. by   handyrn
    Stargazer-you bring up some good points. If I were an ER nurse and didn't know about AD, I would have probably not done anything either until the Dr. saw her. Like I said on another post, when the crisis happens to our own family/friends, we forget to use our brains. We are seeing it from the inside, not from the point of view of the nurse on the "outside."

    I know that my friend knows EVERYTHING there is to know about her condition. I know that she is very in tune with her body. I know that she is not a dramatic person. I know that her Dr. trusts her to know what is going on in her own body. And she knows this too. But the ER staff doesn't know this. And I wasn't looking at it from that perspective, so thanks for making me realize this.

    As for the Dr., I don't remember which one it was, so I don't know if he is a nice guy or not. However, I remember that she had doctored with the same guy for years and I think what happened was that HE knew that she was very in tune to what was going on and knew that the nurses should have believed her, but again, he was looking at it same as me, knowing her personally and his brain went on strike and he lashed out. It's a very small town and when you Dr. with someone for 20 plus years, and see each other in social circles as well, it's hard not to become a personal friend of the doc.

    So again, thanks for opening my eyes.
  7. by   nurseprnRN
    does that thing you gave them to explain about ad have in big red letters at the top something that says "autonomic dysreflexia is a life-threatening complication of sci" ?
    if not, i'd redo it to have that.

    also, offer to come in to a staff meeting do do a brief inservice on it. if this is the place you're going to be going whenever you need er care, you might as well make sure they know you.

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