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Adrenal Crisis Training PowerPoint
Adrenal Crisis Training PowerPoint
Adrenal Crisis
This training was created for teachers and staff associated with students
diagnosed with adrenal insufficiency and suffering from an adrenal crisis.
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Objectives
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State Law
• In 2015 the Oregon legislature amended ORS 433.800 –
433.830 (laws pertaining to the training of lifesaving treatments)
to authorize persons to be trained to administer medication to
students diagnosed with adrenal insufficiency who are suffering
from an adrenal crisis when a licensed health care provider is
not immediately available and whose parent or guardian has
provided the necessary medication and equipment for
administration.
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Conducting Training
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Training Recipients
• The training should be provided on behalf of students with a known
diagnosis of adrenal insufficiency that places them at risk for adrenal
crisis.
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School Health Management Plan
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School Health Management Plan
A School Health Management Plan must include:
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Adrenal Insufficiency
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Adrenal Insufficiency
• Adrenal insufficiency is caused by congenital conditions,
cancers, tumors and many other conditions that affect the
pituitary gland, adrenal gland or other endocrine organs.
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Adrenal Glands
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Daily Medications
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Adrenal Insufficiency vs. Adrenal Crisis
Adrenal Insufficiency: Adrenal Crisis:
– Chronic condition – Acute
– Adrenal glands fail – This is an exacerbation of a
to produce specific students adrenal
stress hormones insufficiency which can be
– The student will caused by:
• Illness
take daily
• Injury
medications
• Stress
• Missing daily medications
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Adrenal Crisis Triggers
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Stress Dose
• When a person who does NOT suffer from adrenal
insufficiency suffers significant physical or emotional stress,
they produce up to 10X the normal amount of hormones
needed in response to the event.
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Stress Dose
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Adrenal Crisis
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Adrenal Crisis
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Crisis Medications
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Treatment
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Medication Access and Storage
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Medication Access and Storage
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Treatment
If you determine that your student is suffering from an
adrenal crisis:
– Instruct someone to call 911 and the student’s parents.
– If the student is still conscious, keep talking to them and
reassure them that you are there to help. Keep them calm.
– Get the injection ready
– Administer the injection and wait with the student until help
arrives.
– The injection will start to take effect in 15 minutes.
– Give the empty vial to the Emergency Medical Responders
when they arrive.
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Equipment Needed
• Non-sterile gloves
• Medication
• Syringe and injection
needle
• Alcohol swab
• Cotton ball or tissue
• Sharps container
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Preparing for Administration
3. Wash hands
4. Put on gloves
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Preparing Medication “Act-o-Vial”
1. Make sure that the medication is clear and not
expired.
2. Press down on the plastic activator (cap) and force
the diluent (liquid) into the lower chamber of
powdered medication. The rubber stopper
separating the two will fall into the lower chamber.
3. Gently mix the solution by turning the vial upside
down several times. DO NOT SHAKE. *The
solution will initially appear cloudy, then clear. If
the solution does not clear, do not administer the
medication to the student and wait for rescue
personnel to arrive.
4. Remove the plastic tab covering the center of the
stopper (small circular disc on the plastic cap).
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Preparing Medication – Reconstitution
1. Use a 4x4 gauze to snap off the top of the
glass ampule.
2. Use a filter needle to draw up all of the fluid
from the glass ampule.
3. Remove the filter needle from the syringe and
replace it with a regular straight needle.
4. Remove the cap from the vial of powder
medication.
5. Insert the syringe and inject the fluid.
6. Gently mix the solution by turning the vial
upside down several times. DO NOT SHAKE.
*The solution will initially appear cloudy, then
clear. If the solution does not clear, do not
administer the medication to the student and
wait for rescue personnel to arrive.
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Drawing Up the Medication
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Administering Medications
5. Uncover the area to be injected (upper thigh or buttock).
6. Use an alcohol swab to cleanse the injection site on the skin.
7. Hold the syringe like a dart.
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Administering Medications
8. Using the thumb and first two fingers, spread the skin while
pushing down lightly.
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Administering Medications
9. Dart the needle into the injection site, going straight into the tissue
at a 90-degree angle.
10. Depress the syringe plunger, administering the drug into the
student.
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Administering Medications
11. With draw the syringe quickly and discard into a sharps container.
12. Use a cotton ball or tissue and massage the injection site gently.
13. Clean up and dispose of waste safely.
14. Remove gloves.
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After Administration of an Injection
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Scenario #1
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Scenario #1 Answer
• Reassure the student that you are there to help and keep them calm.
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Scenario #2
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Scenario #2 Answer
• Treat the student for their skinned knee and monitor them.
• If no other symptoms arise, the student is not at risk for adrenal
crisis.
• Attempt to keep the child relaxed throughout the rest of the day, by
not adding any additional stress and by avoiding emotional triggers.
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Summary
• Students who are diagnosed with adrenal insufficiency
are unable to produce the hormones needed when
responding to specific emotional or physical stressors
such as:
– A broken limb
– A fire drill
– The flu
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Summary
Adrenal crisis is a sudden, severe worsening of
symptoms which may include:
• Severe pain in the lower back, • Red cheeks (not attributed with
abdomen or legs recess or PE class)
• Muscle weakness or cramping • Loss of appetite
• Trouble focusing • Dark rings under the eyes
• Lethargy • Changes in emotional
• Stomach ache behaviors- student may seem
• Nausea and/or vomiting upset, angry or more tearful
than normal
• Diarrhea
• Fainting or passing out
• Dehydration
• Fever (over 100°F)
• Low blood pressure
• Dizziness
• Headache
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Summary
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Summary
When in doubt,
INJECT the student with their STRESS DOSE!
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