How do I install the Enda Glucocorticoid Injection Kit Training skill?

Run npx skillmds@latest add dromlakhani/enda-glucocorticoid-injection-kit-training in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

Is Enda Glucocorticoid Injection Kit Training safe to use?

This skill has not completed SkillMD's automated safety review yet. Independent scanners report: SkillSpector: PASS, Skill Scanner: PASS. Capability flags: docs only. SkillMD never runs a skill's scripts for you; review the SKILL.md before installing.

Which AI agents work with Enda Glucocorticoid Injection Kit Training?

This skill is tagged as working with Claude Code, Claude.ai, OpenAI Codex. SKILL.md is an open format, so most agents that read a skills directory can load it too.

Is Enda Glucocorticoid Injection Kit Training free to use?

Yes. Installing skills from SkillMD is free, and the skill stays under its author's original license.

Who published Enda Glucocorticoid Injection Kit Training?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Enda Glucocorticoid Injection Kit Training by dromlakhani

Name: Enda Glucocorticoid Injection Kit Training
Rating: 4.666666666666667 (3 reviews)
Author: dromlakhani

Enda Glucocorticoid Injection Kit Training

Recommends equipping every patient with primary adrenal insufficiency (PAI) with a glucocorticoid injection kit for emergency self‑administration and providing training on its use. Trigger when preparing a PAI patient for stress dosing, adrenal crisis prevention, or when prescribing glucocorticoid replacement and needing to ensure emergency preparedness.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Provide Glucocorticoid Injection Kit for Emergency Use and Training on Administration

STEP 1 — Gather Information

Confirm diagnosis of PAI via low cortisol with elevated ACTH or failed ACTH stimulation test; review current glucocorticoid and mineralocorticoid doses; assess patient age, cognitive status, and ability to perform self‑injection; verify presence of steroid emergency card and medical alert jewelry.

STEP 2 — Rule In / Rule Out

Rule in if PAI is confirmed and the patient is at risk for adrenal crisis (e.g., prior crisis, intercurrent illness, pregnancy, or planned stressors); rule out if PAI is excluded or the patient lacks capacity for self‑injection and no trained caregiver is available.

STEP 3 — Classify or Stratify

Stratify by age and caregiver availability: adults and adolescents who can self‑inject receive a kit for self‑use; young children or those with cognitive impairment receive a kit designated for caregiver administration.

STEP 4 — Decide

Prescribe a hydrocortisone sodium succinate 100 mg vial with syringe and alcohol swabs, provide a written sick‑day rule sheet, demonstrate IM or SC injection technique, issue or update steroid emergency card and medical alert bracelet, and schedule reinforcement training at each follow‑up visit.

Clinical Guardrails / Mimics / Pitfalls

Do not delay kit issuance pending specialist referral; do not rely on oral dosing alone during suspected adrenal crisis; avoid dexamethasone as first‑line emergency glucocorticoid because it lacks mineralocorticoid activity; ensure patient knows to inject immediately for fever > 38°C, persistent vomiting, trauma, or inability to retain oral meds; do not substitute kit with suppositories unless vomiting precludes injection and suppositories are available.

Concrete Clinical Example

A 34‑year‑old woman with newly diagnosed autoimmune PAI is started on hydrocortisone 20 mg morning, 10 mg evening and fludrocortisone 0.1 mg daily. At the initiation visit, PAI is confirmed, she is taught to self‑inject 100 mg hydrocortisone IM, receives an emergency kit, steroid card, and instruction to double her oral dose for fever > 38°C and to inject if she cannot keep pills down.

Source: Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2015-1710

---name: enda-glucocorticoid-injection-kit-trainingdescription: Recommends equipping every patient with primary adrenal insufficiency (PAI) with a glucocorticoid injection kit for emergency self‑administration and providing training on its use. Trigger when preparing a PAI patient for stress dosing, adrenal crisis prevention, or when prescribing glucocorticoid replacement and needing to ensure emergency preparedness.---# Provide Glucocorticoid Injection Kit for Emergency Use and Training on Administration## STEP 1 — Gather InformationConfirm diagnosis of PAI via low cortisol with elevated ACTH or failed ACTH stimulation test; review current glucocorticoid and mineralocorticoid doses; assess patient age, cognitive status, and ability to perform self‑injection; verify presence of steroid emergency card and medical alert jewelry.## STEP 2 — Rule In / Rule OutRule in if PAI is confirmed and the patient is at risk for adrenal crisis (e.g., prior crisis, intercurrent illness, pregnancy, or planned stressors); rule out if PAI is excluded or the patient lacks capacity for self‑injection and no trained caregiver is available.## STEP 3 — Classify or StratifyStratify by age and caregiver availability: adults and adolescents who can self‑inject receive a kit for self‑use; young children or those with cognitive impairment receive a kit designated for caregiver administration.## STEP 4 — DecidePrescribe a hydrocortisone sodium succinate 100 mg vial with syringe and alcohol swabs, provide a written sick‑day rule sheet, demonstrate IM or SC injection technique, issue or update steroid emergency card and medical alert bracelet, and schedule reinforcement training at each follow‑up visit.## Clinical Guardrails / Mimics / PitfallsDo not delay kit issuance pending specialist referral; do not rely on oral dosing alone during suspected adrenal crisis; avoid dexamethasone as first‑line emergency glucocorticoid because it lacks mineralocorticoid activity; ensure patient knows to inject immediately for fever > 38°C, persistent vomiting, trauma, or inability to retain oral meds; do not substitute kit with suppositories unless vomiting precludes injection and suppositories are available.## Concrete Clinical ExampleA 34‑year‑old woman with newly diagnosed autoimmune PAI is started on hydrocortisone 20 mg morning, 10 mg evening and fludrocortisone 0.1 mg daily. At the initiation visit, PAI is confirmed, she is taught to self‑inject 100 mg hydrocortisone IM, receives an emergency kit, steroid card, and instruction to double her oral dose for fever > 38°C and to inject if she cannot keep pills down.**Source:** Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline, Endocrine Society, 2016, DOI:10.1210/jc.2015-1710

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