Clinical

Sponsor:

Duration: 2010 to 2012

Abstract:

The consequences of uncontrolled spikes in blood pressure, known as autonomic dysreflexia (AD), after spinal cord injury (SCI) are extremely severe. People with SCI have a two-fold higher risk of developing heart disease in comparison to non-injured individuals. Furthermore, cardiovascular dysfunction is currently a leading cause of death among people with SCI.

Despite the presence of the published Paralyzed Veterans of America Guidelines on management and prevention of AD, there are obvious gaps in the distribution of this knowledge outside of SCI rehabilitation centers. Therefore, in accordance with the mission of the PVA Education Foundation, the proposed project is designed to improve the knowledge and skills of health care professionals who serve people with SCI in emergency situations. By educating paramedics, ER physicians and nurses with the specifically designed “ABC of AD” course, we anticipate the early prevention of occurrences and complications related to AD in people with SCI.

Sponsor:

Duration: 2010 to 2012

Abstract:

Evidence suggests that the fluctuation of the relatively lower blood pressure of SCI patients than the normal control is likely to be a risk factor of their impeded cognitive function, as well as the mood status. In the SCI patients with autonomic dysreflexia increased blood pressure is common. This study is to investigate the effects of AD on cognitive and mood functions in patients with spinal cord injury. The aim of the study is not to prove the positive/negative effects of AD on cognitive and mood functions, but to gain information in order to plan a larger study in the future.

Sponsor:

Duration: 2010 to 2012

Abstract:

Presently we have well established and detailed criteria for the blood pressure parameters in able-bodied population and guidelines for the monitoring of changes in these parameters². Unfortunately, at the present time we do not have a full clinical picture of the changes in cardiovascular parameters in individuals with SCI.  Furthermore, we still do not appreciate the full extent of influence of the changes in arterial blood pressure on extend of neurological recovery following this devastating injury.

Aims:

1. To establish a data base with the natural progression and recovery of cardiovascular parameters in individuals with SCI.

2.  To establish the effect of the changes in arterial blood pressure on potential neurological recovery following traumatic SCI.

3.  To develop a guidelines on the acute monitoring and management of cardiovascular parameters for individuals with SCI.

Sponsor:

Duration: 2011 to 2012

Abstract:

Knowledge Translation Goal: To improve knowledge and to change practice on management of life-threatening episodes of cardiovascular emergencies among individuals with spinal cord injury (SCI) by educating Canadian paramedics on evidence based clinical guidelines.

Rationale: Our preliminary data demonstrated that there is a lack of knowledge among paramedics on timely recognition and proper management of life-threatening episodes of autonomic dysreflexia (extremely high blood pressure accompanied by pounding headaches, sweating) which could result in stroke, heart attack, and even death. In fact, cardiovascular abnormalities are currently the leading cause of mortality in persons with SCI.

Knowledge Translation Methods: We will develop a web-based education module on the management of AD for paramedics and paramedic students across Canada (three sites).

Main Messages: The goal of this project is to improve knowledge and change the practice of paramedics by enhancing recognition and management of AD. We ultimately aim to improve health care for people living with SCI by reducing costly and frequently preventable hospital admissions that may result from lack of knowledge on management of this condition.

Sponsor:

Duration: 2008 to 2010

Abstract:

Greater awareness and knowledge on management and appropriate actions for the management of these life threatening conditions in this populations by medical personal outside of the SCI rehabilitation centres could prevent episodes of full blown autonomic dysreflexia (AD) and possibly decrease emergency room (ER) and hospital admissions.

This prospective study will focus on needs assessment and knowledge evaluation of ER physicians and nurses as well as paramedics who are the first line of medical practitioners facing the challenges in management of these conditions.

Purpose: This proposal is focused on evaluating the effect of education on issues of management of chronic secondary cardiovascular conditions in SCI population: autonomic dysreflexia, orthostatic hypotension by the medical personnel of ER and paramedics.

Hypothesis:

H 1. There is a lack of knowledge in the management of unstable blood pressure control incuding the episodes of life threatening autonomic dysreflexia among the medical personnel (ER’s MD,RN and paramedics) who are not involved in care of persons with SCI on a daily basis.

H 2. The introduction of the educational tool (ABC course on AD) will improve the early diagnosis and appropriate management of these conditions.

Sponsor: Duration: January to December 2010

Abstract:

The main goal of the proposed project was to bring evidence-based clinical knowledge and crucial practical information on unstable arterial blood pressure control among athletes with spinal cord injury (SCI) to a worldwide athletic community of Paralympic athletes and coaches who will be participating in Vancouver 2010 Winter Paralympic Games.  Specifically, we educated athletes, caregivers and coaches on the importance of maintaining good cardiovascular health during exercise and sport. This was achieved by creating awareness and promoting understanding of three major cardiovascular consequences of SCI: autonomic dysreflexia , orthostatic hypotension, and the boosting phenomenon.

Sponsor:

Duration: 2009 to 2011

Abstract:

ASTeP is an online training course for the International Autonomic Standards for the Classification of Spinal Cord Injury. The autonomic standards will allow clinicians and researchers to appreciate possible autonomic dysfunctions and to be able to describe the effects of spinal cord injury on bowel, urinary bladder, sexual, cardiovascular, broncho-pulmonary, sudomotor and other autonomic functions.