Endocrine Abstracts

Introduction: Children on long-term steroids are at risk of Addisonian crisis during acute illnesses unless their dose is increased. To prevent this parents receive teaching on correct management if their child becomes unwell. We looked at the effectiveness of this education by assessing parental knowledge.

Methodology: Parents of all children taking long-term steroids under paediatric endocrinology at our hospital between November 2015 and May 2016 were sent a questionnaire regarding the management of acute illnesses in their child. It was based on local and regional guidelines for steroid management. To maximise response rates questionnaires were also distributed opportunistically during attendances on the ward or outpatients.

Results: Out of the 15 of the 22 respondents 100% (15/15) knew their child’s steroid dose, when to seek help and who to contact if their child became unwell. 7% (1/15) did not have an in date hydrocortisone injection at home and 33% (5/15) did not feel confident administering the injection themselves. 87% (13/15) knew to increase the steroid dose during illnesses but only 67% (10/15) knew to give IM hydrocortisone during illnesses if oral steroids were not tolerated, and 73% (11/15) knew to give it for a serious injury. Finally only 40% (6/15) knew to specify a paramedic ambulance when phoning for emergency help.

Discussion: Our survey demonstrates that further improvement in parental education is needed in this group of carers. As there is no national guidance on steroid management during illness we intend to perform a survey (via BSPED membership) of parental knowledge with the aim of creating a national patient information leaflet as well as a clinic checklist. Meanwhile in our clinic a separate leaflet will be introduced that clearly outlines how to alter steroid doses during acute illness as well as a clinic stamp to remind clinicians to check injection expiry date and offer further injection training to parents. We have also written to our regional ambulance service to get clarity on whether a paramedic ambulance is required or whether a standard ambulance crew carries and can administer IM hydrocortisone in our patients (information will be available at the BSPED meeting).