Document ID: chunk:federal_register_of_legislation:F2018L01183:clause:1_2:p1
Version: federal_register_of_legislation:F2018L01183
Segment Type: clause
Provision Reference: sch 1 cl 2 (pt 1/3)
Character Range: 12672–17069

2               Definitions
In this instrument:
     acute, severe stressor means a physical or psychological stimulus or event that causes a sudden, intense psychological or physical response.
Note: Examples of acute, severe stressors include:
            (a)             abrupt cessation or lowering of glucocorticoid therapy;
            (b)            acute hepatic failure;
            (c)             alcohol intoxication;
            (d)            atrial fibrillation;
            (e)             being exposed to an environment of extreme heat during a heatwave;
            (f)             critical illness or injury;
            (g)            dehydration;
            (h)            experiencing a category 1A stressor;
            (i)              experiencing an acute, severe, emotional stressor;
            (j)              febrile illness;
            (k)            gastrointestinal infection;
            (l)              long distance flight;
            (m)           migraine;
            (n)            oesophageal variceal bleeding;
            (o)            physical trauma or injury;
            (p)            serious acute illness;
            (q)            surgery;
            (r)             thyrotoxicosis;
            (s)             undertaking physical activity of five METs or more; and
            (t)              wasp or bee sting.
           Note: category 1A stressor, critical illness or injury, extreme heat and MET are also defined in the Schedule 1 – Dictionary.
                               adrenal crisis means a constellation of symptoms that indicate severe adrenal insufficiency of rapid onset causing acute haemodynamic decompensation.  Characteristic symptoms and signs are hypotension, tachycardia, hypovolaemia (shock), lethargy, hypoglycaemia, disorientation, impaired consciousness, seizures and coma.
         Note 1: Adrenal crisis is a medical emergency that requires treatment with injectable hydrocortisone and fluid support.  Adrenal crisis is also known as an Addisonian crisis.
         Note 2: Adrenal crisis may be the first presentation of undiagnosed adrenal insufficiency, or may complicate existing chronic adrenal insufficiency.
                                  adrenal insufficiency—see subsection 7(2).
                                  category 1A stressor means one of the following severe traumatic events:
         (a)          experiencing a life-threatening event;
         (b)          being subject to a serious physical attack or assault including rape and sexual molestation; or
         (c)          being threatened with a weapon, being held captive, being kidnapped or being tortured.
                               critical illness or injury means any physical injury or illness requiring mechanical ventilation support or admission to an intensive care unit, or which causes septicaemia, adult respiratory distress syndrome, acute renal tubular necrosis, disseminated intravascular coagulation or multiple organ failure.
                               equivalent glucocorticoid therapy means a glucocorticoid in the following table, at the doses specified in the table, or a therapeutically equivalent dose of another glucocorticoid:

 Glucocorticoid      Minimum cumulative  Minimum average
                     dose (milligrams)   rate (milligrams/day)

 betamethasone       18                  0.6
 cortisone           750                 25
 dexamethasone       22                  0.7
 methylprednisolone  120                 4
 paramethasone       60                  2
 prednisolone        150                 5
 prednisone          150                 5
 triamcinolone       120                 4

                               equivalent inhaled glucocorticoid means:
         (a)          800 micrograms of beclomethasone;
         (b)          400 micrograms of fluticasone furoate;
         (c)          1 000 micrograms of fluticasone propionate;
         (d)          4 000 micrograms of triamcinolone; or
         (e)          a therapeutically equivalent dose of another inhaled glucocorticoid.
                               extreme heat means 40 degrees Celsius or above.
                               glucocorticoid therapy as specified means:
         (a)          applying a high or very high potency topical glucocorticoid to at least 10% of total skin surface area, daily, for a