Accident and emergency

Hydrocortisone emergency in pituitary patients

Pituitary conditions are considered rare and A&E Units may only ever see one or two patients with this condition, including those patients who are having an ADRENAL CRISIS.

Hydrocortisone is a steroid produced by the adrenal gland. A good majority of people with pituitary disease have to take replacement hydrocortisone daily, as they don’t produce this naturally. Therefore, as they take replacements, they don’t have the natural surge of Cortisol if they become acutely ill, are vomiting or have severe shock.

In the stressful situations as described above, an emergency hydrocortisone injection is vital! This injection may be needed to save the patient's life. If this injection is delayed, the patient can become very ill, very quickly. Blood pressure drops and coma can occur.

Peak Timings ImageProtocol for pituitary patients with ADRENAL CRISIS

  • Interact with paramedics on their emergency assessment of patient.
  • If a patient hasn’t received their emergency hydrocortisone injection from the ambulance personnel, please give a 100mg injection to the patient urgently.
  • If the attending A&E physician has any doubts, he/she should contact either the on-call Endocrinologist or the on-call consultant physician.

REMEMBER

PITUITARY PATIENT? > TAKING HYDROCORTISONE?> ADRENAL CRISIS? IF YES - INJECT WITH HYDROCORTISONE