Important Contact Information
- Primary Endocrinologist: _________________ Phone: _________________
- Emergency Contact: _________________ Phone: _________________
- Nearest Emergency Department: _________________ Phone: _________________
Warning Signs Requiring Immediate Action
Adrenal Crisis
- Severe weakness or fatigue
- Severe abdominal pain, nausea, vomiting
- Dizziness or fainting
- Confusion or disorientation
- Low blood pressure
Diabetic Emergency
- Blood glucose > 250 mg/dL with ketones
- Blood glucose < 70 mg/dL with confusion
- Severe thirst or dehydration
- Rapid breathing
- Fruity breath odor
Thyroid Storm
- High fever
- Rapid heart rate
- Extreme agitation
- Tremors
- Confusion
Emergency Actions
-
For Adrenal Crisis:
- Inject emergency hydrocortisone
- Call 911 immediately
- Take oral hydrocortisone if conscious
-
For Diabetic Emergency:
- Check blood glucose
- Follow sick day protocol
- Use glucagon kit if hypoglycemic
- Seek immediate medical care
-
For Thyroid Storm:
- Call 911
- Take prescribed beta-blockers if available
- Cool body temperature
Emergency Kit Contents
- Injectable hydrocortisone
- Oral glucocorticoids
- Glucagon kit
- Blood glucose meter
- Ketone test strips
- Emergency medical ID card
Additional Instructions
- Always wear medical alert jewelry
- Keep emergency kit updated and accessible
- Review plan with family members
- Replace expired medications promptly
_Patient Name: _________________
Date: _________________
Endocrinologist Signature: _________________