Success: NSW Ambulance Amends Protocol For Adrenal Insufficiency.

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NSW Ambulance confirmed in writing that changes have been made to the way they handle Adrenal Insufficiency patients request for Hydrocortisone.

The changes come after a complaint I made about the quality of service I received on January 10th following an Assault.

On the night of the incident, I requested a shot of Cortisol from paramedics but was declined. I had advised paramedics and Police that I have Adrenal Insufficiency.

My discharge summary later confirmed I sustained a fractured nose and orbital wall (eye socket).

The letter explained that paramedics acted within the protocol and that my body’s vitals were within ranges set out by the most recent guidelines available to paramedics on January 10th, 2021.

The letter also details changes made to the protocol on 27th March 2021 that state:

‘Paramedics should not discount a request for hydrocortisone administration from a patient with adrenal insufficiency as signs and symptoms of adrenal crisis may vary from patient to patient.’ the letter on July 27th, 2021 reads.

I thank NSW Ambulance for taking notice and implementing changes to the protocols.

I wish to reiterate the importance of speaking up and advocating for positive change.

An adrenal crisis can be life-threatening, always seek immediate medical attention. Call emergency services on 000. Always seek professional advice from a trained medical professional.


  1. Aniko Huizer-Pajkos

    It is shocking that paramedics and medical personnel lack knowledge of adrenal insufficiency and even when asked, they do not provide this lifesaving medication. Giving a shot of hydrocortisone is much cheaper for the government than treating an adrenal crisis.
    Many of the symptoms dwritten on the protocol could be contributed to other diseases and therefore, how would an ambulance officer know whether it is a crisis or not? Also, what happens when the patient is unconscious or unable to respond? All adrenal insufficiency patients should get hydrocortisone immediately in the hospital or ER as stress management to ward off a crisis. Warding off a crisis would be cheaper for the government, easier on staff and safer for the patient. A protocol that provides hydrocortisone only in a crisis shows that it’s authors had no clear knowledge of adrenal insufficiency. Any one who requires an ambulance or evaluation in an ER should get stress dosed immediately as those patients are already under stress and require extra cortisone.

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