Guidance for the prevention and emergency management of adult patients with adrenal insufficiency
File(s)
Published version
Author(s)
Simpson, Helen
Tomlinson, Jeremy
Wass, John
Dean, John
Arlt, Wiebke
Type
Journal Article
Abstract
Adrenal insufficiency (AI) is an often-unrecognised endocrine disorder, which can lead to adrenal crisis and death if not identified and treated. Omission of steroids in patients with AI, particularly during physiological stress such as an intercurrent illness or surgery, can also lead to an adrenal crisis. The National Reporting and Learning System (NRLS) identified 78 incidents including two deaths and six incidents of severe harm to patients in a recent 4-year period. This guidance will go through causes of adrenal insufficiency, groups at risk of an adrenal crisis, emergency management and management for surgical procedures. A new NHS Steroid Emergency Card has been developed to be carried by patients at risk of adrenal crisis. We hope the new emergency card and this guidance will increase awareness of the need to start steroids promptly in patients at risk of an adrenal crisis, particularly those presenting in the emergency department or to acute medicine teams and those undergoing surgery or invasive procedures.
Date Issued
2020-07-01
Date Acceptance
2020-07-01
Citation
Clinical Medicine, 2020, 20 (4), pp.371-378
ISSN
1470-2118
Publisher
Elsevier
Start Page
371
End Page
378
Journal / Book Title
Clinical Medicine
Volume
20
Issue
4
Copyright Statement
© Royal College of Physicians 2020. All rights reserved.
Identifier
https://www.ncbi.nlm.nih.gov/pubmed/32675141
PII: S1470-2118(24)03517-6
Subjects
adrenal crisis
Adrenal insufficiency
AXIS SUPPRESSION
CRISIS
CUSHINGS-SYNDROME
DIAGNOSIS
emergency management
ENDOCRINOLOGY
General & Internal Medicine
GLUCOCORTICOIDS
INHALED CORTICOSTEROID-THERAPY
Life Sciences & Biomedicine
Medicine, General & Internal
RITONAVIR
Science & Technology
steroids
Publication Status
Published
Coverage Spatial
England
Date Publish Online
2020-07-16