endocrinology emergency-medicine
Adrenal Crisis Risk Score
Identifies patients at risk of adrenal crisis (adrenocortical insufficiency during physiological stress). Guides sick day rule for hydrocortisone.
Score interpretation
Low risk
→ Not at immediate risk; follow sick day rules if unwell; double hydrocortisone dose with minor illness
Moderate risk — sick day rules
→ Double or triple oral hydrocortisone; contact endocrinologist; IM hydrocortisone if vomiting
Adrenal crisis likely
→ IV hydrocortisone 100mg stat; IV fluids (0.9% NaCl); admit; continuous cardiac monitoring; cortisol/electrolytes urgently
Interpretation bands for the Adrenal Crisis Risk. Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Drugs
- Hydrocortisone (IV — Paediatric Emergency) · IV Corticosteroid / Adrenal Replacement
- Hydrocortisone with chlorhexidine and nystatin · Topical mild steroid + antibacterial + antifungal
- Hydrocortisone with clotrimazole · Topical mild steroid + antifungal
- Hydrocortisone with fusidic acid · Topical mild steroid + antibacterial
- Hydrocortisone with miconazole · Topical mild steroid + antifungal
- Hydrocortisone with oxytetracycline · Topical mild steroid + tetracycline antibacterial
Pathways
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.