Guest guest Posted July 11, 2012 Report Share Posted July 11, 2012 Failure of cortisol secretion may result in the circulatory collapse and hypotension characteristic of a hypoadrenal or 'ian' crisis.2place in supine position ,maintain airway ,give O2 , obtain IV access, up to 500 mg hydrocortisone immediately ,ensure help is requestedexclude other causes of collapse Preoperative considerations:How much steroid has been taken and for how long? The degree of adrenal suppression depends on the dose and duration of steroid treatment. However the integrity of the adrenal response is not routinely tested and steroid cover or supplements are given according to the surgical stimulus (minor, moderate and major surgery).Dosages of less than 5 mg prednisolone per day are not significant and no steroid cover is required.10 mg/day or more of prednisolone (or equivalent) is generally taken as the threshold dose for 'steroid cover'.Steroid cover is required if taken within three months of the surgery. This is because adrenal suppression can occur after only a week and may take as long as three months to recover.3 From: Mr Happy Tooth <mr.happytooth@...> " " < > Sent: Wednesday, July 11, 2012 10:50 AM Subject: Medical Em question A patient on steroid therapy collapses a few days after extraction..-What might be the cause and what would you do ???-What precautions will you take in such cases ? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2012 Report Share Posted July 11, 2012 thank you very much,very useful to know i would probably think of adr.crisis or smf Kind regardsSana From: Chloe Berg <chloe.berg86@...> " " < > Sent: Wednesday, 11 July 2012, 11:11 Subject: Re: Medical Em question Failure of cortisol secretion may result in the circulatory collapse and hypotension characteristic of a hypoadrenal or 'ian' crisis.2place in supine position ,maintain airway ,give O2 , obtain IV access, up to 500 mg hydrocortisone immediately ,ensure help is requestedexclude other causes of collapse Preoperative considerations:How much steroid has been taken and for how long? The degree of adrenal suppression depends on the dose and duration of steroid treatment. However the integrity of the adrenal response is not routinely tested and steroid cover or supplements are given according to the surgical stimulus (minor, moderate and major surgery).Dosages of less than 5 mg prednisolone per day are not significant and no steroid cover is required.10 mg/day or more of prednisolone (or equivalent) is generally taken as the threshold dose for 'steroid cover'.Steroid cover is required if taken within three months of the surgery. This is because adrenal suppression can occur after only a week and may take as long as three months to recover.3 From: Mr Happy Tooth <mr.happytooth@...> " " < > Sent: Wednesday, July 11, 2012 10:50 AM Subject: Medical Em question A patient on steroid therapy collapses a few days after extraction..-What might be the cause and what would you do ???-What precautions will you take in such cases ? Quote Link to comment Share on other sites More sharing options...
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