Hypotonic saline or 5% dextrose without addition of NS should not be used as can worsen hyponatremia
Neonates: Hydrocortisone 25mg IV/IO
Obtain blood sample for steroid hormone measurement
Most importantly 17-OHP (17-hydroxyprogesterone) to evaluate for 21-hydroxylase deficiency prior to administering hydrocortisone
Most importantly 17-OHP (17-hydroxyprogesterone) to evaluate for 21-hydroxylase deficiency prior to administering hydrocortisone
If significant hypoglycemia, given IV bolus 5-10mL/kg of 10% dextrose (0.5-1.0 g/kg) or 2-4mL/kg of 25% dextrose (D25) infused slowly at rate of 2-3 mL/min
Typically improves promptly after hydrocortisone
Rare occasionally for severe and symptomatic hyperkalemia, administration of glucose and insulin is needed to manage hyperkalemia
Congenital adrenal hyperplasia
Adrenal salt-wasting crisis
Hypothyroidism
THE MISFITS [1]
Levothyroxine toxicity
Trauma
Sheehan's syndrome
Heart