ESPE Abstracts (2014) 82 P-D-1-3-19

Development of Scotland Wide Process for Management of Acute Adrenal Insufficiency

Barbara S Wardhaugha & Jacquie Reidb

aRoyal Hospital for Sick Children, Edinburgh, UK; bRoyal Aberdeen Childrens Hospital, Aberdeen, UK

Background: The Scottish Paediatric Endocrine Managed Clinical Network is committed to providing equity of care across Scotland. A key role identified by the nurses group is developing information leaflets supporting patient care. It was recognized that there was no local unified approach to the management of adrenal insufficiency, especially in the home, community and acute setting. Of particular concern was the lack of a pathway of care from home to hospital and involvement of ambulance staff.

Objective: To develop a national system to improve management of acute adrenal insufficiency.

Method: All patients with known adrenal insufficiency are recorded on a local Hospital Alert System. In conjunction with the Scottish Ambulance Service a national Hazard Alert System has been established. A standard information sheet was designed and piloted. If an Ambulance is requested the crew attending are alerted that the child is at risk of an adrenal crisis and may require administration of i.m. hydrocortisone. Policy remains that ideally parents administer i.m. hydrocortisone prior to arrival of ambulance. In addition a number of information leaflets and teaching guides to improve knowledge and support families in the acute management of adrenal insufficiency have been developed. Information Booklet on Adrenal Insufficiency for Patient/Carer, Information booklet for Schools on Adrenal Insufficiency, Steroid Replacement management plan. Adrenal Insufficiency emergency treatment information card and i.m. injection teaching package.

Conclusion: We now have improved education for Patients and Carers and developed an emergency plan with Scottish Ambulance Service for those children at risk of Adrenal Crisis.

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