We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.
You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.
To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:
On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.
On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.
Please get in touch with ann.wales3@nhs.scot with any questions.
Patients at risk of adrenal crisis should be issued a STEROID EMERGENCY CARD (link here and can be found at www.endocrinology.org/adrenal-crisis)
Patients prescribed steroids at >5mg/day prednisolone (or equivalent) for over 4 weeks are at risk of adrenal suppression and therefore may be at risk of adrenal crisis.
Steroid Equivalence Chart:
|
Steroid |
Dose Equivalent |
|
Prednisolone |
5mg per day or more |
|
Methylprednisolone |
4mg per day or more |
|
Hydrocortisone |
15mg per day or more |
|
Dexamethasone |
250 microgram per day or more |
Dosing recommendation depends on the acute illness AND existing dose and reason for long term steroids. PLEASE check for the appropriate section
Acute Insult - Fever, infection needing antibiotics, surgery under local anaesthetic
Steroids for known Adrenal Insufficiency (any baseline dose)
Double usual glucocorticoid dose, or increase to minimum daily dose of hydrocortisone 30mg or equivalent (if double usual dose <30mg hydrocortisone or equivalent)
Long term steroids with NO known Adrenal Insufficiency
If long-term dose is <10mg prednisolone (or equivalent) → increase dose to 10mg prednisolone (or equivalent) whilst unwell or on day of procedure
Acute Insult - Persistent vomiting, preparation for colonoscopy, acute trauma, surgery under anaestheticFor all patients on long term steroids for ANY indication
On recovery from acute insult - return to normal steroid dose (no need to wean)
For perioperative and obstetric management please discuss with the anaesthetic team and consult national guidance
Patients with confirmed adrenal insufficiency lasting >3 months should be seen in endocrine clinic for education about sick day rules and emergency hydrocortisone injection
Diabetes & endocrinology