DIAGNOSTIC CRITERIA AND EMERGENCY MANAGEMENT ALGORITHMS FOR ACUTE AUTONOMIC DISORDERS IN VETERANS WITH SPINAL CORD INJURY CONSEQUENCES
DOI:
https://doi.org/10.31891/pcs.2026.2.14Keywords:
autonomic dysreflexia, veterans, blast injury, spinal cord, emergency care, physical therapyAbstract
The article investigates the management of autonomic dysreflexia in veterans with blast-induced spinal cord injuries within the scope of physical therapy. In the context of full-scale armed aggression against Ukraine, spinal cord injuries account for up to 34% of polytrauma cases, necessitating the implementation of international rehabilitation protocols and their adaptation to wartime conditions in accordance with national rehabilitation standards.
The study reveals the pathomorphological specifics of blast-induced injuries, characterized by diffuse axonal damage and prolonged neuroinflammation. These features form a unique vegetative profile in veterans with a low excitability threshold, where minimal stimuli can provoke uncontrolled sympathetic activation. Diagnostic markers of autonomic dysreflexia are systematized, identifying a sudden increase in systolic blood pressure of 20 mmHg or more above the patient's baseline as the primary criterion. This allows physical therapists to objectively detect the onset of a crisis and distinguish it from physiological responses to exercise. Special attention is paid to the differential diagnosis between dysreflexia and post-traumatic stress disorder. The study determines that the key differential indicator is the heart rate pattern: paradoxical bradycardia in autonomic dysreflexia versus tachycardia in anxiety-related states.
An emergency management algorithm is substantiated, including the immediate cessation of exercises, placing the patient in a seated position, and a systematic search for triggers. The risks associated with functional electrical stimulation and intensive verticalization are analyzed. A complex of preventive strategies is proposed, including mechanical compression and patient education through the implementation of autonomic dysreflexia medical alert cards. These recommendations are aimed at improving the safety and efficacy of the rehabilitation process for veterans with spinal cord injury consequences.
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