Changes to ambulance staff guidelines for treating adrenal crisis

During the last nine months The Foundation has been involved in a review process of the guidelines for adrenal crisis produced by The Joint Royal Colleges Ambulance Liaison Committee. We were invited by The Association of Ambulance Chief Executives to take part. This was an excellent opportunity to improve current guidance as these guidelines are used by all ambulance staff in the UK.

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We are delighted to announce that our recommendations have been incorporated to the UK manual. Therefore, there is now more detailed information available to ambulance staff which will hopefully help improve awareness regarding the treatment of patients experiencing an adrenal crisis. 

Our recommendations to the review were:

  • The guidelines include a list for ambulance staff of all conditions that can be red flagged by an ambulance service. We have ensured adrenal crisis has been added to this list as it was not included previously. This should be beneficial in spreading awareness that an adrenal crisis is life threatening, many of our patients are now red flagged with their ambulance trust following our awareness campaign about this in 2015.
  • The guidelines now specify Addison’s disease (primary adrenal insufficiency) and pituitary deficiency (secondary adrenal insufficiency). Previously only Addison’s was mentioned. There can be a lack of understanding that pituitary patients with secondary adrenal insufficiency require the same emergency treatment so we were keen to suggest this alteration and are pleased it could be incorporated.
  • We asked for dizziness to be added to the list of key warning signs and symptoms for ambulance staff to look out for.
  • The guidelines originally didn’t mention IM (intramuscular injection). IV (intravenous injection) acts quicker and would be preferable but if an ambulance technician has no IV training then IM should be an option and could save lives. This is now mentioned in the guidelines.

The Ambulance Liaison Committee are launching the new manual on Wednesday 20th September, at the first day of The Emergency Services Show. Following the launch date each ambulance service will be going through a process to ensure their paramedics have access to the new guidelines.

The Foundation will continue our work to improve awareness of adrenal insufficiency, we are always happy to work with organisations and health care professionals. The Foundation would like to thank The Association of Ambulance Chief Executives who invited us to take part in this review, and also to Prof John Wass and Addison’s Disease Self Help Group who we worked with closely during this review as they were also taking part.