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Standardisation of the management of acutely unwell children with known adrenal insufficiency.
This clinical protocol should be used in children with known adrenal insufficiency who present acutely unwell.
Conditions: Children on daily replacement hydrocortisone treatment, eg.
On Arrival in Emergency Department Ensure Urgent Clinical Assessment and contact Endocrine team |
Child may already be on double hydrocortisone therapy and possibly received intramuscular dose of hydrocortisone at home. Beware clinical improvement may be due to IM hydrocortisone. |
Age |
Hydrocortisone Bolus |
Hydrocortisone infusion |
<6months |
12.5mg |
1ml/hr |
6 months-5years |
25mg |
1ml/hr |
5-10years |
50mg |
2ml/hr |
>10years |
100mg |
3ml/hr |
DO NOT DISCHARGE HOME without discussing with endocrine team
Last reviewed: 24 May 2022
Next review: 24 May 2023
Author(s): Guftar Shaikh
Version: 5
Approved By: Paediatric Clinical Effectiveness & Risk Committee
Document Id: 239