What is an adrenal crisis?
Adrenal crisis is a life-threatening situation where a person’s cortisol level has significantly dropped.
Common causes of adrenal crisis are:
- sudden onset diarrhoea and/or vomiting
- a rise in body temperature to above 38c
- significant accident or injury
- for some significant psychological stress such as bereavements or witnessing trauma.
We have a fact sheet which outlines the signs to be aware of that may indicate impending adrenal crisis and advice on how to respond.
Emergency Treatment of Adrenal Crisis
- Immediate 100mg Hydrocortisone i.v. or i.m. injection. Followed by 24 hr continuous i.v. infusion of 200mg Hydrocortisone in Glucose 5% OR 50mg Hydrocortisone i.v. or i.m. qds (100mg if severely obese)
- Rapid rehydration with Sodium Chloride 0.9%.
- Liase with Endocrinology team.
The Society for Endocrinology have further guidance for dealing with adrenal crisis.
Sick Day Rules
When a patient with adrenal insufficiency undergoes a situation where their body may produce raised levels of cortisol, patients need to adhere to the sick day rules. We have a factsheet for patients that offers advice on the sick day rules.