RT Journal Article SR Electronic T1 Guidance for the prevention and emergency management of adult patients with adrenal insufficiency JF Clinical Medicine JO Clin Med FD Royal College of Physicians SP 371 OP 378 DO 10.7861/clinmed.2019-0324 VO 20 IS 4 A1 Helen Simpson A1 Jeremy Tomlinson A1 John Wass A1 John Dean A1 Wiebke Arlt YR 2020 UL http://www.rcpjournals.org/content/20/4/371.abstract AB Adrenal insufficiency (AI) is an often-unrecognised endocrine disorder, which can lead to adrenal crisis and death if not identified and treated. Omission of steroids in patients with AI, particularly during physiological stress such as an intercurrent illness or surgery, can also lead to an adrenal crisis. The National Reporting and Learning System (NRLS) identified 78 incidents including two deaths and six incidents of severe harm to patients in a recent 4-year period. This guidance will go through causes of adrenal insufficiency, groups at risk of an adrenal crisis, emergency management and management for surgical procedures. A new NHS Steroid Emergency Card has been developed to be carried by patients at risk of adrenal crisis. We hope the new emergency card and this guidance will increase awareness of the need to start steroids promptly in patients at risk of an adrenal crisis, particularly those presenting in the emergency department or to acute medicine teams and those undergoing surgery or invasive procedures.