Stress dose steroids: Difference between revisions
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==Emergency corticosteroid suplementation in patients taking exogenous [[corticosteroids]]== | |||
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| Minor procedure or surgery under local anesthesia (eg, inguinal hernia repair)||No extra supplementation is necessary||Continue normal dosing | | Minor procedure or surgery under local anesthesia (eg, inguinal hernia repair)||No extra supplementation is necessary||Continue normal dosing | ||
|- | |- | ||
| Moderate surgical stress (eg, lower extremity revascularization, total joint replacement)||50 mg hydrocortisone IV ||25 mg of hydrocortisone every eight hours for 24 hours. Resume usual dose thereafter. | | Moderate surgical stress (eg, lower extremity revascularization, total joint replacement)||50 mg [[hydrocortisone]] IV ||25 mg of hydrocortisone every eight hours for 24 hours. Resume usual dose thereafter. | ||
|- | |- | ||
| Major surgical stress (eg, esophagogastrectomy, total proctocolectomy, open heart surgery)||100 mg hydrocortisone IV ||50 mg every eight hours for 24 hours. Taper dose by half per day to maintenance level. | | Major surgical stress (eg, esophagogastrectomy, total proctocolectomy, open heart surgery)||100 mg [[hydrocortisone]] IV ||50 mg every eight hours for 24 hours. Taper dose by half per day to maintenance level. | ||
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===Pediatric Dose=== | |||
“Emergent Intramuscular Dosing can be given if child is not tolerating oral medications” <ref>[https://pedemmorsels.com/stress-dose-steroids/ Stress Dose Steroids BY SEAN M. FOX PED EM MORSELS]</ref>or unable to get IV within 15 minutes. | |||
'''IM hydrocortisone sodium succinate''' (Solu-Cortef) | |||
*25 mg for child 3 years and younger | |||
*50 mg for children >3 yrs – 12 years | |||
*100 mg for children 12 years and older. | |||
[[Category:Endocrinology]] | |||
[[Category:Critical Care]] | |||
Latest revision as of 10:39, 7 December 2019
Emergency corticosteroid suplementation in patients taking exogenous corticosteroids
| Category | Initial | Subsequent |
| Minor procedure or surgery under local anesthesia (eg, inguinal hernia repair) | No extra supplementation is necessary | Continue normal dosing |
| Moderate surgical stress (eg, lower extremity revascularization, total joint replacement) | 50 mg hydrocortisone IV | 25 mg of hydrocortisone every eight hours for 24 hours. Resume usual dose thereafter. |
| Major surgical stress (eg, esophagogastrectomy, total proctocolectomy, open heart surgery) | 100 mg hydrocortisone IV | 50 mg every eight hours for 24 hours. Taper dose by half per day to maintenance level. |
Pediatric Dose
“Emergent Intramuscular Dosing can be given if child is not tolerating oral medications” [1]or unable to get IV within 15 minutes. IM hydrocortisone sodium succinate (Solu-Cortef)
- 25 mg for child 3 years and younger
- 50 mg for children >3 yrs – 12 years
- 100 mg for children 12 years and older.