Clinical Pathway for the Child at Risk for Adrenal Suppression:
Stress Steroid Dosing and Weaning Recommendations
- Related Pathway
- Emergent/Critical Dosing Required
- Based on Patient Condition
- Steroid duration not immediately available
- Use Hydrocortisone IV, IM
- Severe Stress Only
- Age 0-24 mos: 25 mg
Age 25 mos to 10 yrs: 50 mg
Determine if Severe or Moderate Stress
Based on procedure, severity of illness
Based on procedure, severity of illness
Stress dose is based on patient's current maintenance dose
Give daily dose of dexamethasone and ADD stress dose hydrocortisone
Hold daily dose and give
stress dose
stress dose
Case Examples:
Determining Stress Level Weaning Glucocorticoids
Determining Stress Level Weaning Glucocorticoids