Possible adrenal crisis? Use your prescribed emergency plan and seek emergency medical care. Adrenal crisis

04 Adrenal Crisis

Adrenal crisis

How to recognize warning signs, use your prescribed emergency plan, and keep an emergency kit ready.

If adrenal crisis is suspected, use your prescribed emergency plan and seek emergency medical care. Do not wait on this website, Ask ADDI, or a chatbot.

What adrenal crisis is

Adrenal insufficiency is a serious medical condition in which the body cannot produce adequate cortisol, an essential hormone needed to respond to illness, injury, infection, surgery, dehydration, severe stress, or other physical demands.

When cortisol levels become critically low, a person may develop an adrenal crisis. In educational terms, that is a situation in which the body cannot meet the cortisol demand placed on it. Adrenal crisis is a medical emergency that can progress rapidly and may become life-threatening without prompt treatment.

People living with adrenal insufficiency or long-term steroid dependence require emergency glucocorticoid treatment during medical emergencies or periods of severe physical stress. Follow the product, amount, and method in the written orders and teaching from your clinician.

Crisis symptoms and warning signs

Symptoms can include:

Severe weakness or extreme fatigue
Vomiting or inability to keep oral medications down
Dizziness or fainting
Confusion or changes in mental status
Severe dehydration
Severe abdominal pain
Low blood pressure or collapse
Infection with fever
Significant injury, surgery, or blood loss

What to do in a crisis

Lead with the plan that was prescribed for you:

Use your prescribed emergency plan. Follow the written instructions and injection teaching from your clinician.
If adrenal crisis is suspected, call emergency services or seek urgent medical care.
Tell responders and clinicians that you have adrenal insufficiency and that you need glucocorticoid treatment according to your emergency orders, letter, or protocol.

Emergency injection kit — what to assemble

Many people with adrenal insufficiency carry emergency steroid medication, injectable emergency medication kits, emergency medical information cards, and clinician-approved emergency treatment plans. Discuss what belongs in your kit with your prescribing clinician. Typical items include:

The emergency glucocorticoid injection your clinician prescribed
Syringes and needles as prescribed
Alcohol swabs
Gloves
Your written emergency letter or protocol
Medical identification
Extra oral steroids if prescribed
Caregiver instructions, in language the people who help you can follow

Monthly quality and expiration check

Check the kit every month. Inspect supplies for damage, discoloration, expiration dates, and completeness (medication, delivery supplies as prescribed, letter/protocol, medical ID, and caregiver instructions). Replace anything expired, damaged, missing, or discolored with help from your pharmacist and prescribing clinician.

Types of emergency injections

Emergency kits are not all the same. Patients may be prescribed different glucocorticoid preparations. Some people are prescribed hydrocortisone sodium succinate in a product such as an Act-O-Vial or Solu-Cortef-type vial. Some clinicians use other injectable glucocorticoids.

Only use the injection your clinician prescribed and taught you.

After you seek care — tell the hospital

Tell hospital staff you have adrenal insufficiency and that adrenal crisis is a concern.
Give them your emergency letter, protocol, medical identification, and any medication you already used as prescribed.
Ask them to follow your clinician’s emergency instructions and their own clinical judgment.

EMS protocols by state

EMS PROTOCOLS BY STATE (CARES Foundation)

Related emergency information

The shorter emergency hub remains on this site for quick reference. This adrenal crisis page is the deeper preparedness destination.

Adrenal insufficiency emergency information

This page is educational, not individualized medical advice. It is not a substitute for emergency medical services or the emergency plan your clinician prescribed. Questions about your care belong with your clinician. Medical disclaimer.