Quadriplegia & Body Temperature Regulation
Did you know that many people with high-level spinal cord injuries cannot regulate their body temperature? Not only that but their bodies do not sweat to cool down or shiver to warm up. It can be a pain in the butt for a person just wanting to get out of the house in the middle of summer or winter. For caregivers, why this happens, how to avoid hypo- and hyperthermia is extremely important (pretty much as important as how to manage autonomic dysreflexia). Even more important than that is how to treat someone who has become overheated or under heated. The excerpt below from Apparelyzed explains what is know as poikilothermia, or variable body temperature.
Poikilothermic And Poikilothermia
Temperature Regulation Overview
A normal, healthy human is able to maintain a constant body temperature of approximately 98.6F despite the temperature of the environment. In a hot environment, the body sends a signal to the brain via the spinal cord to say the body is overheating, the brain then sends a signal back down the spinal cord and tells the body to cool itself by perspiration which evaporates and cools the skin. In cold weather, the body senses the lower temperature and our brain tells us to put more clothes on to warm ourselves up.
Spinal Cord Injury Temperature Regulation
Most people with complete spinal cord injuries do not sweat below the level of the injury and many quadriplegics cannot even sweat above the injury (even though they may sweat due to autonomic dysreflexia). With loss of the ability to sweat or vasoconstrict within affected dermatomes the patient becomes poikilothermic and needs careful control of their environmental conditions. Therefore, if a high paraplegic or quadriplegic is in an outside temperature over 90 F, especially when the humidity is high, the body temperature will begin to rise (Poikilothermia). Likewise in a cold environment, the body may not be able to get the messages through to the brain that the body is cooling down, and if left untreated, the person will soon become hypothermic.
Cooling Down With a Spinal Cord Injury
One of the best ways for a person with a spinal cord injury to cool down is to have a cold wet towel wrapped around the back of the neck. The skin should also be damped down to allow the water to evaporate from the skin, and hence cool the body down. It’s a bit like artificial sweat, but it does work. A cold water spray on the head and shoulders will help reduce the body temperature. The most obvious way to keep cool is to sit in the shade!
Some of the symptoms of overheating that quadriplegics may suffer from are a headache, nasal congestion, tiredness and reduced concentration.
Warming up With a Spinal Cord Injury
If a person gets too cold, then layers of clothing should be worn, and warm fluids should be drank to bring the core temperature back up to normal.
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