EMOttawa - By Josee Malette - March 16, 2023
Conclusion
- Consider THYROID STORM as a potential Zebra in any of your “Hot and Crazy” presentations, especially when no alternative cause can be found.
- Recognition of Thyroid Storm is the most important.
- Thyroid storm is a CLINICAL DIAGNOSIS. Composed of a triad of pyrexia, AMS and tachycardia, with end-organ damage evidence on biochemical assays.
- In the ED, treatment should focus on early administration of MMI or PTU (Thyroid Peroxidase Inhibitors), to inhibit the synthesis of additional thyroid hormone. In addition to acute rescucitation of your ABCs.
- Be cautious of the use of beta-blockers in the severe thyroid storm with shock. Assess LV function and risk of cardiogenic shock before preceding with their administration.