We recently identified an error on two of our publications: the Adrenal Crisis Guidelines form, and the ADSHG Steroid Emergency Card.

As we explain in this article, this correction does not impact patient safety. However it's essential our clinical information is accurate. To avoid any confusion for clinicians who may use the leaflet and/or card as guidance, we immediately updated both documents. Therefore if you have old versions of these publications from us, we would ask you to please throw them away. 

You can find full details in this article, including what the error was and the action we have taken.

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How do I know if I have an incorrect version?

If you have a copy of the old design of both the Adrenal Crisis Guidelines or ADSHG steroid emergency card, as pictured, please throw these copies away. Additonally, these were printed before the new NICE Guidelines were released. 

Some of our new design, as pictured, have also been affected. Please check the monitoring section within the leaflet and/or card, as detailed below, to see if your copies of the new design are affected.

Monitoring Dose

The error is in the monitoring section of the guidance. So you can also check by reading your leaflet and/or card, and if under monitoring it reads 100mg (as highlighted in the image below with the blue arrow), these should be replaced.

It is important not to confuse the urgent treatment section, with the monitoring section of the guidance, as we explain in 'The Error'.

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The Error

Both of these documents offer important guidance on the management of adrenal crisis to clinicians. This includes mention of the monitoring that a patient may need following an adrenal crisis, when in hospital. In one place in the guidance in our leaflet is the following content: 

• 100mg hydrocortisone every 6 hours, intravenous or intramuscular OR by infusion pump, e.g. 200mg per 24 hours.

This should read,

• 50mg hydrocortisone every 6 hours, intravenous or intramuscular OR by infusion pump e.g. 200mg per 24 hours.

In terms of impact on patient safety, there is no toxic dose of hydrocortisone in an emergency. Additionally, based on what has triggered your adrenal crisis, the monitoring hydrocortisone dose will be tailored to your individual needs until clinical recovery and additional guidance by an endocrinologist. The monitoring dose given is guidance.   

In both of our updated versions of the documents, clinicians are sign-posted to the Society for Endocrinology adrenal crisis guidance and the NICE Guidelines. 

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Next Steps

We are keen to emphasise, so as to comfort our community, that the correction does not impact patient safety. However providing accurate clinical information is necessary and we have immediately worked to get these documents updated.

What we've done

The free download of the Adrenal Crisis Guidelines is available for you to print at home, or to replace a digital copy you may have. Printed copies of both the leaflet and the card are also now available on our online shop. 

For anyone who recently purchased these items from our online shop, or received a Welcome Pack or Hospital Folder, we've emailed you directly so these can be replaced free of charge. All ADSHG charity members have also been emailed and offered free paper copies from our online shop and notified of the digital option of the leaflet if that is their preference. All of this information has also been posted on our online forum to help reach people in multiple ways.

If you are an ADSHG charity member, you would have received this email on Thursday 20 November 2025. If you did not, please check your Junk Folder as we are aware some of our emails go there by mistake.

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Your Concerns

Thank you for your support of our small charity and your understanding. Should you have concerns and wish to contact us, please do not hesitate to email: [email protected]