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Autonomic dysreflexia (AD) is an acute, life-threatening syndrome of uncontrolled sympathetic discharge that occurs in patients with spinal cord injury at T6 or higher. Despite a high incidence in tetraplegics, the condition is under-recognized, putting both the practitioner and patient at risk. This report presents a case of AD triggered by debridement of a pressure ulcer. To advance the understanding among wound care practitioners, the authors review the literature, describe the common clinical presentations and scenarios leading to AD, delineate a protocol to guide management, and conclude with a discussion of potential preventative measures. .