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Because of your spinal cord injury, the temperature of your body
has an increased tendency to fluctuate according to the
temperature of the environment. If you are in a hot room your
temperature may increase (hyperthermia); if you are in a cold
room, your temperature may decrease (hypothermia). This occurs
because of the altered function of the autonomic nervous system.
The higher the level of injury, the greater the tendency for
fluctuations in your body temperature.
Hypothermia refers to an decresae in body temperature. For
example, it may occur on a cold day if you are out-of-doors,
sitting in a cold car, or not wearing sufficient outdoor
clothing . A consequence of lesions above T6 is the body's
inability to regulate body temperature effectively anymore.
This usually means an inability to warm the body's extremities
properly too.
Measured orally, a healthy person's body temperature can
fluctuate between 97°F (36.1°C) and 100°F (37.8°C). Survival
depends on maintaining temperature stability within this range
by balancing the heat produced by metabolism with the heat lost
to the environment through (for the most part) the skin and
lungs. When environmental or other changes cause heat loss to
outpace heat production, the brain triggers physiological and
behavioral responses to restore the balance. The involuntary
muscular activity of shivering, for example, aids heat
production by accelerating metabolism. But if the cold stress is
too great and the body's defenses are overwhelmed, body
temperature begins to fall. Hypothermia is considered to begin
once body temperature reaches 95°F (35°C), though even smaller
drops in temperature can have an adverse effect.
Hypothermia is divided into two types: primary and secondary.
Primary hypothermia occurs when the body's heat-balancing
mechanisms are working properly but are subjected to extreme
cold, whereas secondary hypothermia affects people whose
heat-balancing mechanisms are impaired in some way and cannot
respond adequately to moderate or perhaps even mild cold.
Primary hypothermia typically involves exposure to cold air or
immersion in cold water. The cold air variety usually takes at
least several hours to develop, but immersion hypothermia will
occur within about an hour of entering the water, since water
draws heat away from the body much faster than air does. In
secondary hypothermia, the body's heat-balancing mechanisms can
fail for any number of reasons, including strokes, diabetes,
malnutrition, bacterial infection, thyroid disease, spinal cord
injuries (which prevent the brain from receiving crucial
temperature-related information from other parts of the body),
and the use of medications and other substances that affect the
brain or spinal cord. Alcohol is one such substance. In smaller
amounts it can put people at risk by interfering with their
ability to recognize and avoid cold-weather dangers. In larger
amounts it shuts down the body's heat-balancing mechanisms.
Secondary hypothermia is often a threat to the elderly, who may
be on medications or suffering from illnesses that affect their
ability to conserve heat. Malnutrition and immobility can also
put the elderly at risk. Some medical research suggests as well
that shivering and blood vessel narrowing-two of the body's
defenses against cold-may not be triggered as quickly in older
people. For these and other reasons, the elderly can, over a
period of days or even weeks, fall victim to hypothermia in
poorly insulated homes or other surroundings that family,
friends, and caregivers may not recognize as life threatening.
Another risk for the elderly is the fact that hypothermia can
easily be misdiagnosed as a stroke or some other common illness
of old age.
The signs and symptoms of hypothermia follow a typical course,
though the body temperatures at which they occur vary from
person to person depending on age, health, and other factors.
The impact of hypothermia on the nervous system often becomes
apparent quite early. Coordination, for instance, may begin to
suffer as soon as body temperature reaches 95°F (35°C). The
early signs of hypothermia also include cold and pale skin and
intense shivering; the latter stops between 90°F (32.2°C) and
86°F (30°C). As body temperature continues to fall, speech
becomes slurred, the muscles go rigid, and the victim becomes
disoriented and experiences eyesight problems. Other harmful
consequences include dehydration as well as liver and kidney
failure. Heart rate, respiratory rate, and blood pressure rise
during the first stages of hypothermia, but fall once the 90°F
(32.2°C) mark is passed. Below 86°F (30°C) most victims are
comatose, and below 82°F (27.8°C) the heart's rhythm becomes
dangerously disordered. Yet even at very low body temperatures,
people can survive for several hours and be successfully
revived, though they may appear to be dead.
Skin Breakdown
pneumonia
Osteoporosis and Fractures
Heterotopic Ossification
Spasticity
Urinary Tract
Infections
Autonomic Dysreflexia
Deep Vein Thrombosis
Pulmonary Embolism
Orthostatic Hypotension
Cardiovascular Disease
Syringomyelia
Neuropathic / Spinal Cord Pain
Medication Problems
Hyperthermia
Hypothermia
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