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Steroid Emergency Card to support early recognition and treatment of adrenal crisis in adults

A joint National Patient Safety Alert has been issued by NHS Improvement and NHS England national patient safety team, Royal College of General Practitioners, Royal College of Physicians and Society for Endocrinology, regarding the introduction of a new Steroid Emergency Card to support the early recognition and treatment of adrenal crisis in adults.

About this alert

All patients with primary adrenal insufficiency are steroid dependent and some patients, who take oral, inhaled or topical steroids for other medical conditions, may develop secondary adrenal insufficiency and become steroid dependent.

The omission of steroids for patients with primary or secondary adrenal insufficiency can lead to adrenal crisis; a medical emergency which if left untreated can be fatal. If these patients become acutely ill or are subject to major body stressors, such as from trauma or surgery, they require higher doses of steroids to prevent an adrenal crisis.

While substantial resources exist, clinical staff are not always aware of the risk of adrenal crisis, or the correct clinical response should one occur.

Recently issued national guidance promotes a new patient-held Steroid Emergency Card to help healthcare staff identify patients with adrenal insufficiency and provide information on emergency treatment if the patient is acutely ill, experiences trauma, surgery or other major stressors.

The alert asks providers to ensure all eligible patients are issued with a Steroid Emergency Card; and to put processes in place to check if a patient has a Steroid Emergency Card ahead of any emergency treatment, elective surgery, or other invasive procedures.

You can view the new Emergency Steroid Card on the Society for Endocrinology’s Adrenal Crisis Information webpage.

About National Patient Safety Alerts

This alert has been issued as a National Patient Safety Alert.

The NHS England and NHS Improvement patient safety team is the first national body to have been accredited to issue National Patient Safety Alerts by the National Patient Safety Alerting Committee (NaPSAC). All National Patient Safety Alerts are required to meet NaPSAC’s thresholds and standards. These thresholds and standards include working with patients, frontline staff and experts to ensure alerts provide clear, effective actions for safety-critical issues.

NaPSAC requires providers to introduce new systems for planning and coordinating the actions required by any National Patient Safety Alert across their organisation, with executive oversight.

Failure to take the actions required under any National Patient Safety Alert may lead to CQC taking regulatory action.

Patient safety alerts are shared rapidly with healthcare providers via the Central Alerting System (CAS).

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