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When these patients present for surgery, the anesthesiologist must decide whether to administer perioperative stress-dose steroids to mitigate this rare but Are Stress-Dose Steroids Indicated in Patients with Adrenal Insufficiency . She was discharged home in stable condition, with instructions to complete a course Adrenal response to stress can vary broadly from patient to patient. many textbooks advocate to counter problems associated with excessive steroid dosing. 1 Dec 2016 Why are stress instructions necessary? Because you suffer from adrenal insufficiency, your adrenal glands don't produce enough cortisol. EMERGENCY ROOM INSTRUCTIONS I am/my child is adrenally insufficient and steroid de- pendent. today (includes any stress dosing for the day):26 Jan 2017 Stress Steroid Management. This document is only valid for the day on which it is accessed. Please read our disclaimer. Management of adrenal insufficiency during the stress of medical illness and surgery or surgery without the risk of an adrenal crisis or excessive steroid dosing. .. serious omissions can occur as a result of inadequate or unclear instructions Pathway for the Child at Risk for HPA Suppression: and ADD stress dose hydrocortisone. Adrenal Axis Function After High-Dose Steroid Therapy for Childhood Acute Lymphoblastic Leukemia + 1. For fever up to 103 degrees, double-up on regular steroid dose. For example, if your child usually takes 5 mg cortef twice daily, take 10 mg twice daily as stress dosing.