Addisonian crisis
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Medical Emergency - Addisonian crisis is an emergency that needs sorting to prevent death from shock!
What is it?
An acute episode of adrenal insufficiency. That means the adrenal glands stop producing cortisol. This leads to, amongst other things, you having no blood pressure, and having no blood sugar.
How does it present?
Patients are in shock, or perhaps just bad postural hypotension. May also be hypoglycaemic.
Classically presents in:
- Patients with known Addison's disease.
- Patients on long term steroids who have forgotten a dose.
- Patients who have been in trauma that has knackered the pituitary, and thus stopped the release of ACTH
What do you do?
- Sort out the shock.
- Take blood for cortisol and ACTH
- Give them Hydrocortisone sodium succinate 100mg IV stat.
- Check blood sugar, since that going in to a hypoglycaemic coma is a bit of a downer.