Advocacy Efforts >>Emergency Medical Response for CAH
Emergency Medical Response for CAH
Did you know that most ambulances do not carry Solu-cortef®? Furthermore, they are not allowed to administer the shot even if you have it? We are working to develop EMS protocols for emergency medical treatment of CAH and other adrenal insufficiencies. Too many people suffer from delayed medical care in emergency situations. (Join the discussion: EMS Experiences)
Adrenal Crisis and EMS - EMS Pediatric Continuing Education Credit Course through NM EMSC (online)
Status as of October 2011
CARES Foundation
Working to Make CAH Emergency Medical Response a Reality Across the Country
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Roll your mouse over the map; click on a state for more details
No EMR for CAH
EMR campaign underway
Protocol development underway
Protocols adopted in certain regions
Admin. of patient carried medications
State protocols adopted; regional impl. required
Protocols approved; impl. pending
EMR for CAH protocols in place
EMS Campaign
Since 2009, CARES Foundation has been advocating for immediate, appropriate emergency medical response for adrenal crisis.
Current EMS protocols of many states do not:
address adrenal insufficiencies
allow emergency medical response personnel to treat individuals with
medical id that says "adrenal insufficiency" on it
doctor's orders that detail medical treatment protocols for adrenal crisis
properly labeled medications
Why is this important?
People who do not have adrenal insufficiencies naturally produce up to ten times the normal amount of cortisol, which is vital to the maintenance of blood pressure and heart muscle tone, as well as sugar and salt balance, during times of physical stress. When illness or injury occurs in adrenally insufficient individuals, however, an immediate additional dose of glucocorticoids (hydrocortisone) is necessary to avert adrenal crisis. Delay in administration of these medications can lead to shock, heart failure and death.
Signs of adrenal crisis, which are not readily identifiable, include:
Pallor
Dizziness
Headache
weakness/lethargy
abdominal pain
vomiting/nausea
hypoglycemia
hypotension
shock
heart failure
Individuals affected by CAH are not always in the immediate care of someone trained in or comfortable with administration of a hydrocortisone injection. For example: a child at school when there is no school nurse, an adult affected by CAH living alone, an automobile accident in which the caregiver is incapacitated, a family on holiday outside of their “home” support network. Thus, it is important to be able to rely on EMS during an adrenal crisis.
CARES Foundation advocates for the inclusion of treatment for adrenal insufficiency in EMS protocols with on-going appeals across the nation.
Emergency medical responders have training, protocols and medications necessary to provide immediate appropriate medical response when treating individual with medical alert identification marked “adrenal insufficiency”
(According to a recent CARES Foundation-sponsored survey, 75% of individuals affected by CAH wear medical alert identification)
All US emergency management systems’ (EMS) formularies include Solu-Cortef® which is:
drug of choice for treatment of CAH in times of adrenal crisis
provides both glucocorticoid and mineralocorticoid coverage
CARES Foundation members and support groups are leading initiatives for the expansion of emergency medical response protocols to include the pre-hospital treatment for adrenal insufficiency in numerous states across the country.
How You Can Help
In those states where we have on-going campaigns, concerned residents can make a huge impact.Affected individuals and their families can truly help our appeal by getting involved and urging the addition of Solu-Cortef® to EMS formularies and emergency treatment protocols for CAH and other adrenal insufficiencies. Look at the chart below to learn more about your state. Please take the time to write a letter, visit your local firehouse and join a campaign. (Then email us what you did at ProgramManager@caresfoundation.org.) Together we can make a real difference!
State
Ambulances Carry Solu-Cortef
Administer Patient Carried Solu-Cortefand/or Ambulances Carry Solu-Medrol
*Protocols for the Administration of patient-carried medications available in Clark County since January 2011, Southern Nevada since early 2010, and North Lake Tahoe since May 2011
*State guidelines for regional adoption of protocols approved and Solu-Cortef added to statewide formulary in December 2009! Regional-level implementation campaign required. Suffolk County in place since July 2009, Nassau County and Western NY since May 2011
Contact local EMS and urge them to adopt state protocols
Statewide protocol development underway. Administration of patient-carried protocol adopted in Southwestern Vermont (District 12); implementation planned for January 2012.
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