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Community pharmacies must source and supply Steroid Emergency Cards

By Isabel Shaw

20 Aug 2020

English community pharmacies must ensure they can store and supply Steroid Emergency Cards to offer as replacements to patients who lose or damage their own, NHS England has said.

A ‘critical’ National Patient Safety Alert, published by NHS England last week (13 August), outlined how patients with primary adrenal insufficiency can help healthcare staff treat them by carrying a Steroid Emergency Card.

It said that the cards are to be issued by prescribers to ‘all eligible patients prescribed steroids’, while community and hospital pharmacies must store spares for patients who need a replacement. The pocket-size card, which states ‘this patient is physically dependent on daily steroid therapy as a medicine’, provides healthcare staff with information on the emergency treatment to start if the patient is ‘acutely ill, or experiences trauma, surgery or other major stressors,’ the alert said.

This update follows recent guidance from the Society for Endocrinology Clinical Committee and the Royal College of Physicians Patient Safety Committee, which suggested a new patient-held Steroid Emergency Card should be issued to all patients who require steroid therapy, in order to prevent an adrenal crisis.

According to the guidance, ‘omission of steroids for patients with adrenal insufficiency can lead to an adrenal crisis; a medical emergency which if left untreated can be fatal’.

‘Patients with adrenal insufficiency require higher doses of steroids if they become acutely ill or are subject to major body stressors, such as from trauma or surgery, to prevent an adrenal crisis,’ it added.

It is important these patients carry cards because ‘some clinical staff are not aware of the risk of adrenal crisis or the correct clinical response should one occur,’ the NHS England alert said.

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