endocrinology emergency-medicine

Adrenal Crisis Risk Score

Guidance on adrenal-crisis risk and sick-day rules in people with adrenal insufficiency or on long-term glucocorticoids. There is no validated points score — the page's tally was not a published method.

Result

There is no validated points score for adrenal-crisis risk. People with adrenal insufficiency or on long-term glucocorticoids are at risk during physiological stress (infection with fever, vomiting or diarrhoea, surgery, trauma) and after missed doses. Sick-day rules: double the usual glucocorticoid dose during a febrile illness; use the emergency injection and seek emergency care if vomiting, unable to take tablets or collapsing. Suspected crisis (hypotension, vomiting, abdominal pain, confusion, hyponatraemia or hyperkalaemia): treat at once without waiting for results — Adults: hydrocortisone 100 mg IV or IM, then 200 mg per 24 hours (or 50 mg every 6 hours), with 1 L 0.9% sodium chloride in the first hour (Society for Endocrinology 2016). Children: use a children's formulary.

References

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

References

Related