- Consider administration of steroids in patients with shock that is unresponsive to appropriate IV fluid resuscitation and vasopressors.
- Consider adrenal crisis in any patient who has risk factors (particularly chronic steroids), an acute stressor, and vague systemic symptoms.
- Hydrocortisone is the steroid of choice in patients with adrenal insufficiency given it’s glucocorticoid and mineralocorticoid action.
- Etomidate has not been shown to cause clinically significant adrenal suppression. Use it for RSI in any appropriate clinical setting.