Lock It In
Priority Goals
Recognize that a patient taking current or recent glucocorticoids may be unable to generate the cortisol surge needed for infection, trauma, surgery, or severe vomiting.
- Recognize that a patient taking current or recent glucocorticoids may be unable to generate the cortisol surge needed for infection, trauma, surgery, or severe vomiting. - Treat hypotension, vomiting, weakness, abdominal pain, hypoglycemia, or altered mental status in an at-risk patient as possible adrenal crisis until emergency treatment has begun. - Match the route to the patient’s condition: oral dosing requires reliable absorption and hemodynamic stability; vomiting, diarrhea, anesthesia, or instability require parenteral hydrocortisone. - Never omit the patient’s maintenance glucocorticoid on the morning of surgery; it may be their only available cortisol source.