Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings.

Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research
Bradley S MillerKyriakie Sarafoglou

Abstract

Adrenal insufficiency (AI) remains a significant cause of morbidity and mortality in children with 1 in 200 episodes of adrenal crisis resulting in death. The goal of this working group of the Pediatric Endocrine Society Drug and Therapeutics Committee was to raise awareness on the importance of early recognition of AI, to advocate for the availability of hydrocortisone sodium succinate (HSS) on emergency medical service (EMS) ambulances or allow EMS personnel to administer patient's HSS home supply to avoid delay in administration of life-saving stress dosing, and to provide guidance on the emergency management of children in adrenal crisis. Currently, hydrocortisone, or an equivalent synthetic glucocorticoid, is not available on most ambulances for emergency stress dose administration by EMS personnel to a child in adrenal crisis. At the same time, many States have regulations preventing the use of patient's home HSS supply to be used to treat acute adrenal crisis. In children with known AI, parents and care providers must be made familiar with the administration of maintenance and stress dose glucocorticoid therapy to prevent adrenal crises. Patients with known AI and their families should be provided an Adrenal Insufficienc...Continue Reading

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Citations

Nov 29, 2020·The Journal of Clinical Endocrinology and Metabolism·Donatella CapalboMariacarolina Salerno
Sep 4, 2020·Seminars in Respiratory and Critical Care Medicine·Gennaro MartucciKarin Amrein
Jul 21, 2021·Archives of Endocrinology and Metabolism·Lia Mesquita LousadaTania A S S Bachega
Oct 1, 2021·Journal of Pediatric Endocrinology & Metabolism : JPEM·Patrick T ReevesNoelle S Larson

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