Resources to support safer bowel care for patients at risk of autonomic dysreflexia

A resource Patient Safety Alert has been issued to support safer provision of bowel care for patients at risk of autonomic dysreflexia.

Patient Safety Alerts are shared rapidly with healthcare providers via the Central Alerting System (CAS).

About this alert

Patients with spinal cord injury or neurological conditions may have neurogenic bowel dysfunction, which often means they depend on routine interventional bowel care, including the digital (manual) removal of faeces (DRF).

Some of these patients, especially those with spinal cord injury above T6, are particularly susceptible to the potentially life-threatening condition autonomic dysreflexia, which is characterised by a rapid rise in blood pressure, risking cerebral haemorrhage and death. 

Autonomic dysreflexia can be caused by non-adherence to a patient's usual bowel routine or during or following interventional bowel care.

Following reports of patient safety incidents around significant delays in providing DRF, or an appropriate alternative, this alert provides links to a range of resources to support safer bowel care for patients at risk of autonomic dysreflexia, and highlights the publication of NHS England’s updated Excellence in continence care framework, which addresses how providers can overcome implementation challenges.


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