Emergency MedicineEndocrinology
Adrenal Crisis
Society for Endocrinology — recognition and immediate management of adrenal crisis; emergency hydrocortisone, fluids, glucose, sick-day rules.
Source: Society for Endocrinology Emergency Guidance (2024)
Step 1 of ~4
info
Recognise Adrenal Crisis
Hypotension ± shock unresponsive to fluids, hyponatraemia, hyperkalaemia, hypoglycaemia, vomiting, abdominal pain, fever, weakness, ALOC. Risk: known Addison's, hypopituitarism, long-term steroid use (≥5 mg prednisolone ≥4 weeks), bilateral adrenalectomy. Triggers: infection, surgery, missed dose, GI illness.
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Hydrocortisone (IV — Paediatric Emergency) · IV Corticosteroid / Adrenal Replacement
- Insulin (IV Infusion — ICU Glucose Control) · Insulin — ICU Glucose Management
- Hydrocortisone (ICU — Stress Dosing) · Corticosteroid (ICU/Septic Shock)
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Labetalol (IV — Hypertensive Emergency) · Combined Alpha-1 and Beta-Adrenergic Blocker
- Hydrocortisone (Topical) · Mild Topical Corticosteroid
Pathways
- Difficult Airway Algorithm (DAS) · DAS 2015; Royal College of Anaesthetists
- Major Haemorrhage Protocol · NICE NG24; UK MHP guidelines
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only. Always apply local guidelines and clinical judgement.