Suspected Adrenal Crisis Medical Directive

Question 1

Suspected Adrenal Crisis Medical Directive

Answer 1

A Primary Care Paramedic may provide the treatment prescribed in this Medical Directive if authorized.

Question 2

Indications

Answer 2

A patient with primary adrenal failure who is experiencing clinical signs of an adrenal crisis.

Question 3

Conditions - Hydrocortisone

Answer 3

Age: N/A
LOA: N/A
HR: N/A 
RR: N/A
SBP: N/A
Other: Paramedics are presented with a vial of hydrocortisone for the identified patient
AND
Age-related hypoglycemia OR
GI symptoms (vomiting, diarrhea, abdominal pain) OR
Syncope OR
Temperature ≥38C or suspected/history of fever OR
Altered level of awareness OR
Age-related tachycardia OR
Age-related hypotension

Question 4

Contraindications - Hydrocortisone

Answer 4

Allergy or sensitivity to hydrocortisone

Question 5

Treatment

Answer 5

Consider hydrocortisone

Question 6

Consider hydrocortisone

Answer 6

Route: IM/IV
Dose: 2 mg/kg*
Max. single dose: 100 mg
Dosing interval: N/A
Max. # of doses: 1
*Dose should be rounded to the nearest 10 mg

Question 7

Clinical Considerations

Answer 7

IV administration of hydrocortisone applies only to PCP’s authorized for PCP Autonomous IV.