What is an adrenal crisis?

Adrenal crisis is a life-threatening situation where a person’s cortisol level has significantly dropped.

Common causes of adrenal crisis are:

  • sudden onset diarrhoea and/or vomiting
  • a rise in body temperature to above 38c
  • significant accident or injury
  • for some significant psychological stress such as bereavements or witnessing trauma.

We have a fact sheet which outlines the signs to be aware of that may indicate impending adrenal crisis and advice on how to respond.

Emergency Treatment of Adrenal Crisis

  1. Immediate 100mg Hydrocortisone i.v. or i.m. injection. Followed by 24 hr continuous i.v. infusion of 200mg Hydrocortisone in Glucose 5% OR 50mg Hydrocortisone i.v. or i.m. qds (100mg if severely obese)
  2. Rapid rehydration with Sodium Chloride 0.9%.
  3. Liase with Endocrinology team.

The Society for Endocrinology have further guidance for dealing with adrenal crisis.

Sick Day Rules

When a patient with adrenal insufficiency undergoes a situation where their body may produce raised levels of cortisol, patients need to adhere to the sick day rules. We have a factsheet for patients that offers advice on the sick day rules.