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    <div class="center sliding">Autonomic Dysreflexia</div>
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      <div class="content-block-title">Features</div>
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          <li>this is a medical emergency</li>
          <li>most common sources are bowel and bladder</li>
          <li>most common injury levels at risk are T6 and rostral</li>
          <li>pounding headache</li>
          <li>hypertension</li>
          <li>profuse sweating and flushing above the level of injury</li>
          <li>blurry vision</li>
          <li>sudden rise in BP generally greater than 20 mmHg (trend baseline)</li>
          <li>bradycardia</li>
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      <div class="content-block-title">Risk Factors</div>
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          <li>injuries T6 and higher</li>
          <li>complete injuries</li>
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      <div class="content-block-title">Treatment</div>
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          <li>Sit patient upright</li>
          <li>Loosen clothing</li>
          <li>Relieve obstruction to drainage of an indwelling urinary catheter. If no indwelling catheter present then catheterize</li>
          <li>If the systolic blood pressure is still 150 mmHg or greater administer rapidly acting and easily reversible antihypertensives such as nitropaste</li>
          <li>If the systolic blood pressure is less than 150 mmHg then the rectum should be manually disimpacted</li>
          <li>Search for other precipitants if symptoms persist</li>
           <li>Consider using lidocaine jelly before bowel routine if AD triggered by bowel routine</li>
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                <div class="item-title">References</div>
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                 <p>Garstang SV WH. Spinal Cord Medicine. Kirshblum S. C, D, editor. 2nd ed.: LWW; 2011. Chapter 9, Cardiovascular and autonomic dysfunctions after spinal cord injury. p.136-154.</p>

                 <p>Kirshblum S, Nieves J, Clark D, Gonzalez P, Cuccurullo SJ, Luciano L. Physical Medicine and Rehabilitation Board Review. Cuccurullo SJ LJ, editor. 3 rd ed. New York, NY: Demos Medical; 2015. Chapter 7, Spinal cord injuries. p.551-620.</p>

                 <p>Partida E, Mironets E, Hou S, Tom VJ. Cardiovascular dysfunction following spinal cord injury. Neural Regen Res 2016 Feb;11(2):189-194.</p>

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