We recently identified an error within two of our publications: the Adrenal Crisis Guidelines form and the ADSHG wallet steroid emergency card.
As we explain in this article, this correction does not impact patient safety. However, it is essential that our clinical information is accurate, and both of these documents offer important guidance on the management of adrenal crisis to clinicians. To avoid any confusion for clinicians who may use the leaflet and/or card as guidance, we immediately updated both documents.
Therefore, if you have old versions of these publications from us, we would ask you to please throw them away.
You can find full details in this article, including what the error was and the action we have taken.
How do I know if I have an incorrect version?
If you have a copy of the old design of both the Adrenal Crisis Guidelines or ADSHG steroid emergency card, as pictured here, please throw these copies away.
Additionally, these were printed before the new NICE Guidelines were released.
Some of our newer design (shown on the right) have also been affected.
Please check the monitoring section within the leaflet and/or card, as detailed below, to see if your copies of the new design are affected.
The error
The error is a typo in the 'Monitoring Required' section of the guidance. Check by reading your leaflet and/or card, and if, under monitoring, it reads 100mg (as highlighted in the image below with the blue arrow), this is inaccurate, and your copies should be replaced.
This includes mention of the monitoring that a patient may need following an adrenal crisis, when in hospital. In one place in the guidance in our leaflet is the following content:
100mg hydrocortisone every 6 hours, intravenous or intramuscular OR by infusion pump, e.g. 200mg per 24 hours.
This should read,
50mg hydrocortisone every 6 hours, intravenous or intramuscular OR by infusion pump e.g. 200mg per 24 hours.
The impact of the error
In terms of impact on patient safety, there is no toxic dose of hydrocortisone in an emergency.
Additionally, based on what has triggered your adrenal crisis, the monitoring hydrocortisone dose is guidance only, and will be tailored to your individual needs until clinical recovery and additional guidance by an endocrinologist.
In both of the updated versions of the documents, clinicians are signposted to the Society for Endocrinology adrenal crisis guidance and the NICE Guidelines.
Next Steps
We are keen to emphasise, so as to comfort our community, that the correction does not impact patient safety. However, providing accurate clinical information is necessary, and we have immediately worked to get these documents updated.
What we've done
- The updated Adrenal Crisis Guidelines is available for you to view and download to print at home, or, to replace a digital copy you may have.
Printed copies of both the leaflet and the card are also now available on our online shop.
Download the Adrenal Crisis Guidelines
Buy a printed copy of the Adrenal Crisis Guidelines
- The updated version of our ADSHG wallet steroid emergency cards is available to purchase from our shop
Buy the ADSHG wallet steroid card
For anyone who recently purchased these items from our online shop, or received a Welcome Pack or Hospital Folder, we've emailed you directly so these can be replaced free of charge.
All ADSHG charity members have also been emailed and offered free paper copies from our online shop and notified of the digital option of the leaflet if that is their preference. This information has also been posted on our online forum to help reach people in multiple ways.
Your Concerns
Thank you for your support of our small charity and your understanding.
Should you have concerns and wish to contact us, please do not hesitate to email: opsmanager@addisons.org.uk