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

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 ear...

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Autores principales: Miller, Bradley S, Spencer, Sandra P, Geffner, Mitchell E, Gourgari, Evgenia, Lahoti, Amit, Kamboj, Manmohan K, Stanley, Takara L, Uli, Naveen K, Wicklow, Brandy A, Sarafoglou, Kyriakie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996103/
https://www.ncbi.nlm.nih.gov/pubmed/30819831
http://dx.doi.org/10.1136/jim-2019-000999
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author Miller, Bradley S
Spencer, Sandra P
Geffner, Mitchell E
Gourgari, Evgenia
Lahoti, Amit
Kamboj, Manmohan K
Stanley, Takara L
Uli, Naveen K
Wicklow, Brandy A
Sarafoglou, Kyriakie
author_facet Miller, Bradley S
Spencer, Sandra P
Geffner, Mitchell E
Gourgari, Evgenia
Lahoti, Amit
Kamboj, Manmohan K
Stanley, Takara L
Uli, Naveen K
Wicklow, Brandy A
Sarafoglou, Kyriakie
author_sort Miller, Bradley S
collection PubMed
description 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 Insufficiency Action Plan, including stress hydrocortisone dose (both oral and intramuscular/intravenous) to be provided immediately to EMS providers and triage personnel in urgent care and emergency departments. Advocacy efforts to increase the availability of stress dose HSS during EMS transport care and add HSS to weight-based dosing tapes are highly encouraged.
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spelling pubmed-69961032020-02-18 Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings Miller, Bradley S Spencer, Sandra P Geffner, Mitchell E Gourgari, Evgenia Lahoti, Amit Kamboj, Manmohan K Stanley, Takara L Uli, Naveen K Wicklow, Brandy A Sarafoglou, Kyriakie J Investig Med Review 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 Insufficiency Action Plan, including stress hydrocortisone dose (both oral and intramuscular/intravenous) to be provided immediately to EMS providers and triage personnel in urgent care and emergency departments. Advocacy efforts to increase the availability of stress dose HSS during EMS transport care and add HSS to weight-based dosing tapes are highly encouraged. BMJ Publishing Group 2020-01 2019-02-28 /pmc/articles/PMC6996103/ /pubmed/30819831 http://dx.doi.org/10.1136/jim-2019-000999 Text en © American Federation for Medical Research 2020. Re-use permitted under CC BY-NC. No commercial re-use. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, an indication of whether changes were made, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Review
Miller, Bradley S
Spencer, Sandra P
Geffner, Mitchell E
Gourgari, Evgenia
Lahoti, Amit
Kamboj, Manmohan K
Stanley, Takara L
Uli, Naveen K
Wicklow, Brandy A
Sarafoglou, Kyriakie
Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings
title Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings
title_full Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings
title_fullStr Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings
title_full_unstemmed Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings
title_short Emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings
title_sort emergency management of adrenal insufficiency in children: advocating for treatment options in outpatient and field settings
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6996103/
https://www.ncbi.nlm.nih.gov/pubmed/30819831
http://dx.doi.org/10.1136/jim-2019-000999
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