So we're back with Adam Thomas for the internet booker of critical care.

And we're going to talk about adrenal crisis.

And this one's going to be an awesome podcast.

It's going to be focused.

And it's one of those things I have to admit, Josh, I forget sometimes when my patients

in front of me, they're crushing with oppressors.

They're super sick. I think about the usual types of shock, they're crushing with the pressers, they're super sick.

I think about the usual types of shock, like the hypovalemia, the obstructive. But I have to admit,

I sometimes miss the metabolic cause. So today we'll talk about the epi, the presentation,

testing, treatment, and prevention. And then you're going to help us remind ourselves how to keep this at the forefront

of our minds when someone's sick, because it's not all our patients, but it's one of those

things we need to remember.

Yeah.

So remember in this post, we're going to separate somewhat our discussion of patients who have

known adrenal insufficiency versus patients who have potential or suspected adrenal insufficiency.

Okay.

So I'm forgetting it all the time,

Josh. I need to keep this in my back burner of my mind. Talk to me about the epidemiology of

patients who are at risk for this. So probably the vast majority of cases of adrenal crisis that we're

going to see are folks with chronic adrenal insufficiency exposed to a stressor. And practically speaking, this is mostly going to be folks who are chronic steroid therapy.

So anytime someone rolls into the ED, I always look at the pre-admission medication.

It's always a good thing.

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