Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
First 5 minutes
Airway risk
Depressed mental status
Refractory shock
Breathing support
High flow oxygen for hypoxemia
Ventilation if fatigue or hypercapnia
Circulation
Two large bore IV or IO
Cardiac monitor and defibrillation pads
Point of care glucose within minutes
Time critical therapy
Hydrocortisone immediately if suspected
Do not delay steroids for labs
Shock recognition and triggers
Adrenal crisis phenotype
Hypotension or shock
SBP < 90 mmHg
MAP < 65 mmHg
Vasopressor requirement
Volume depletion
Tachycardia
Poor capillary refill
Oliguria
Metabolic features
Hypoglycemia
Hyponatremia
Hyperkalemia
High risk context
Known adrenal insufficiency
Chronic glucocorticoid use with recent reduction
Recent surgery or severe infection
Monitoring and targets
Resuscitation targets
MAP target 65 mmHg
Higher target for chronic hypertension
Lactate clearance trend if elevated
Urine output target 0.5 mL/kg/hour
Foley if shock or strict I and O
Glucose target 4.0 to 10.0 mmol/L
Dextrose support if recurrent hypoglycemia
Electrolyte safety
Potassium trend and ECG changes
Sodium correction rate safety
Key concepts
Core pathophysiology
Absolute or relative cortisol deficiency
Reduced vascular tone and catecholamine responsiveness
Impaired gluconeogenesis and glycogenolysis
Mineralocorticoid deficiency in primary adrenal insufficiency
Renal sodium wasting
Hyperkalemia and metabolic acidosis
Precipitating stress with inadequate stress dose steroids
Infection
Surgery
Trauma
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.