Suspected Adrenal Crisis Medical Directive

Question 1

What are the indications?

Answer 1

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

Question 2

What are the conditions for hydrocortisone?

Answer 2

• 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 >38 c or suspected/ hx of fever OR
  Age-related tachycardia OR
  Age-related hypotension

Question 3

What are the contraindications for hydrocortisone?

Answer 3

• Allergy or sensitivity to hyrdocortisone

Question 4

What is the treatment for hydrocortisone?

Answer 4

• Route= IM/IV
• Dose= 2mg/kg
• Max. single dose= 100mg
• Dosing interval= n/a
• Max. # of doses= 1

*Dose should be rounded to the nearest 10 mg

Question 5

What are the clinical considerations?

Answer 5

• IV administration of hydrocortisone applies only to PCP’s authorized for PCP Autonomus IV