Online education resources are available to you and your loved ones.

The information presented in this on page is educational and not intended as medical advice or the practice of medicine. Specific aspects of your outcomes and care should be addressed and answered after consultation with your physician.

Patient Education: Spinal Cord Injury Community Resources

Paralyzed Veterans of America sets the standard in Clinical Practice Guidelines for healthcare practitioners at all levels and all those who care for individuals living with Spinal Cord Injury and Disease (SCI/D).

Learn from the Clinical Practice Guidelines »

The International Spinal Cord Society (ISCoS) module has been developed for and in close collaboration with the SCI consumers. Education about the injury is an important component of a comprehensive rehabilitation for person with SCI.

Learn about SCI »

United Spinal Association is dedicated to empowering people with spinal cord injuries and disorders (SCI/D), including veterans, to live successful and fulfilling lives.

Learn more about United Spinal Association »

The Christopher & Dana Reeve Foundation is dedicated to curing spinal cord injury by advancing innovative research and improving quality of life for individuals and families impacted by paralysis. There are many ways to get support, get involved and donate to support the Reeve Foundation mission.

Learn more about the Foundation »

The Wheelchair Skills Program (WSP) is a set of free online low-tech, high-impact, evidence-based resources for the assessment and training of the wheelchair skills of users (with or without the assistance of caregivers) of manual wheelchairs, powered wheelchairs and motorized mobility scooters.

Find training resource from the Wheelchair Skills Program »

Spinal Cord Injury BC is a team of sexual health clinicians and specialists in Vancouver, BC providing specialist sexual health services, education and research in British Columbia, Canada.

Learn more about sexual health from Spinal Cord Injury BC »

Wheelchair Travel is the world's largest accessible travel resource, with information about inclusive travel for disabled people, wheelchair friendly destinations and more.

Find travel resources at Wheelchair Travel »

The University of Alabama at Birmingham Spinal Cord Injury Model System (UAB-SCIMS) maintains the Information Network as a resource to promote knowledge in the areas of research, health and quality of life for people with spinal cord injuries, their families, and SCI-related professionals. Here, you will find our educational materials and information on research activities of the UAB-SCIMS along with links to outside (Internet) information.

Find resources from the UAB-SCIMS Information Network »

Wheelchair to Car Transfer

Emily Potter, OTR, discusses the addition of hand controls on vehicles and shows how she transfers from a wheelchair to her car.

CAUTIs and Spinal Cord Injury Webinar

Matthew E. Davis, MD, Clinical Medical Director, SCI, of TIRR Memorial Hermann presents a webinar about safety and quaility considerations for CAUTIs and spinal cord injury.

Medical Alert Autonomic Dysreflexia

I have a Spinal Cord Injury. I am susceptible to a medical emergency known as Autonomic Dysreflexia (AD), which results in a dangerous rise in blood pressure. It is caused by an unusual/painful stimulus below my injury level – including areas that do not feel pain. The most common causes are bladder over distension and constipation. My baseline blood pressure may be low, so a blood pressure more than 20mmHg above my usual baseline may indicate a serious problem. Blood pressures that may not be worrisome in able-bodied people may result in a seizure, stroke or cardiac dysfunction if AD is left untreated. Once the cause of AD is found, blood pressure returns back to normal on its own.

If you don't know what to do, call 911.

  • BP above my baseline
  • Slow or rapid pulse
  • Pounding headache
  • Flushing, paling, red blotches on skin
  • Chills without fever, goose bumps
  • Stuffy nose
  • Anxious
  • Seizure
  • Large pupils
  • Blurred vision
  1. Most common cause: Irritation of the bladder, usually due to overfill, spasm, infection, stones, plugged catheter or kinked tubing
  2. Second most common cause: constipation, over distension of the bowel.
  3. Pinched testicles, menstrual cramps, sexual activity or pregnancy
  4. Skin injuries: burns, pressure injuries, constant pressure on skin from clothing, binder, wrinkled sheets or shoes.
  5. Ingrown toenail, fractures, trauma below level of injury, abnormal bony growth or acute abdomen
  6. Painful procedure or surgery. Any painful stimulus.
  7. Extreme changes in temperature (overheating)

Hypertension resolves when the cause of pain stimulus is found.

  1. Raise my head and keep it elevated; put me in a sitting position.
  2. Take blood pressure, if higher than baseline, proceed to step
  3. Loosen clothing and remove tight clothing (abdominal binder, hose).
  4. Check testicles to make sure not pinched, make sure not sitting or lying on anything.
  5. Check catheter for kinks, clogged tube, full bag.
  6. If indwelling catheter, change it or flush with 60cc Normal Saline.
  7. If no catheter in place, catheterize me to immediately drain my bladder.
  8. Take blood pressure again, if still higher than 150 systolic or 90 diastolic (normal BP for person with SCI may be 90/60).
  9. Apply numbing medication, such as Dibucaine or Lidocaine (if available), insert finger into rectum and remove any stool.
  10. Check skin for irritation (keep my head up while changing positions)
  11. Check for ingrown toenail and apply lidocaine jelly.
  12. If still high blood pressure after 15 - 20 minutes, call 911 to go to Emergency Room with list of medications and this card.

Manually Assisted Coughing

Following a spinal cord injury, excess mucus and secretions can accumulate in the lungs. Paralysis of chest and abdominal muscles results in loss of ability to cough effectively. Assisted cough is necessary to aid the person in removing secretions from the lungs, and is performed by applying manual pressure to the upper abdomen as the person attempts to cough. It can be performed in a variety of ways, but the basic principles for each method are the same. If patient has an IVC filter, hand position changes to side.

Hand Placement:
  1. To Assist a Person in Bed: Place the heel of your hands below the rib cage with your thumbs resting together over the xiphoid process and your fingers pointing upwards over the ribs. Be careful not to exert pressure with thumbs over the xiphoid process.
  2. To Assist a Person in a Wheelchair (Heimlich type maneuver): Back the wheelchair up to a sturdy surface (e.g., wall, sofa) and lock the brakes to prevent the wheelchair from tilting over backwards. You may want to position yourself in front of the person in a squatting or kneeling position. Locate the xiphoid process and place the heel of one hand just below it. Place the other hand on top of the first, keeping the fingers open or interlocked. Be careful not to exert pressure with thumb or fingers over the xiphoid process.

Additional Resources for Managing Autonomic Dysreflexia

Patient & Professional Education: Disorders of Consciousness Resources

Patient & Caregiver Resources

Professional Resources:

Patient & Professional Education: Neurogenic Bladder Resources

BladderBuzz Podcast: What's Neurogenic Bladder? - For Professionals*

If you treat patients with this disorder, come listen to this (podcast) episode for an introduction and discussion of common misconceptions that have meaningful implications for your patients.

Listen to the BladderBuzz Podcast »

BladderBuzz Podcast: What's Neurogenic Bladder? - For Patients & Families*

If you, a family member or a friend struggles to understand and manage neurogenic bladder, this (podcast) episode is for you.

Listen to the BladderBuzz Podcast »

BladderBuzz Podcast: Mental Health During a Pandemic

Are you feeling down, less energized, socially isolated or generally fatigued after 2020? Join us for this episode of Beyond the Bladder, where we discuss issues that you have suggested are relevant to our Bladder Buzz listeners.

Listen to the BladderBuzz Podcast »

BladderBuzz Podcast: Dating and Relationships

If you have a mobility impairment and use a wheelchair or other assistive device and you’re concerned about how others might view a romantic relationship with you, then come along on the beginning of this new adventure with Ms. Wimbish and Dr. Denny.

Listen to the BladderBuzz Podcast »

Back to Top

Contact Us

If you have questions or are looking for more information, please complete the form below and we will contact you.


Thank you for contacting the TIRR Memorial Hermann. We have received your inquiry, and a team member will contact you soon.

If you need more immediate assistance, please call us at (800) 44-REHAB (73422).

If you are experiencing a medical emergency, call 911 or go to the nearest emergency room.

Patients & Visitors