A cortisol deficient patient who becomes unwell or has an accident can have a life threatening adrenal crisis if not correctly managed. Adrenal crisis is a significant cause of morbidity and mortality for these patients. Treatment can be started at home or at the site of the accident by the parents/carers by giving an IM hydrocortisone, this reduces the risk significantly.Background
Around 700 children and families in GOSH and many more nationally are taught how to manage illness and accidents for their children and part of the training includes how to administer an IM injection of hydrocortisone. Currently this is not produced in ‘epipen’ format and needs to be drawn up using a needle and syringe from a glass vial, a complex task for a parent with their very sick child in front of them. Repeat teaching is given as requested in clinic, but often only means one parent is updated. Many people look after these children in the community so we needed a wider reach. We designed a tool that would guide them through this process simply and safely at a very stressful time.Strategy
The original idea was to simply develop a training video so parents/carers could view the injection in real time to either refresh themselves or to guide the administration if needed. This was filmed and embedded onto the endocrine pages of the GOSH website. The response to this from the parents in clinic was overwhelmingly positive. The disadvantage is that to watch it relies on a 3/4G signal being available. Many times this is not available so the focus then was to develop it into an app ‘My Cortisol’.Results and conclusion
The app has been downloaded over 4500 times across the world and has been endorsed by the British Society of Paediatric Endocrinology and Diabetes and was also selected a finalist at the RCN Nurse awards for Innovations in Nursing.