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Originator: National Patient Safety Alert - NHS England & NHS Improvement

Issue date: 13-Aug-2020 10:00:18

This alert has been issued to:
  • Care Trusts
  • Mental Health Trusts
  • Specialists Trusts
  • NHS Regional Offices
  • Learning Disabilities Trusts
  • Mental Health & Social Care Trusts
  • Ambulance Trusts
  • Mental Health & Learning Disabilities Trusts
  • Acute Trusts
  • Community Trusts

  • Other contacts
  • Independent Healthcare Providers (registered with CAS)
  • Clinical Commissioning Groups
  • GP - Locum
  • NHS 111 and Out of hours providers
  • GP Practices
  • Primary Care Networks

Action category: Immediate Action

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

Broadcast content:
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.

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.

The Emergency Steroid Card can be ordered from:
a) NHS Forms, Print, Exemptions, Cards and EIHC: http://www.nhsforms.co.uk 
b) Primary Care Support England (PCSE online): https://secure.pcse.england.nhs.uk/_forms/pcsssignin.aspx 

Additional information: NHS England and NHS Improvement regional offices - please cascade this alert to community pharmacy.

Alert reference: NatPSA/2020/005/NHSPS

Action underway deadline: 18-Aug-2020

Action complete deadline: 13-May-2021


Contact our helpdesk

Email: safetyalerts@mhra.gov.uk

Medicines and Healthcare products Regulatory Agency