Thyroid Storm in the Emergency Department

ABSTRACT:

Audience:

Emergency medicine residents of all levels, and emergency medicine medical students.

Introduction:

Thyroid storm represents the extreme manifestation of thyrotoxicosis.1  It ranks as one of the most critical illnesses in the spectrum of endocrine emergencies.1  Recognition and appropriate management of life-threatening thyrotoxicosis is vital to prevent the high morbidity and mortality that may accompany this disorder. The incidence of thyroid storm has been noted to be less than 10% of patients hospitalized for thyrotoxicosis; however, the mortality rate due to thyroid storm ranges from 20%-30%.1  This simulation case allows the trainee to practice important critical decision-making skills in the evaluation and management of a patient presenting with thyroid storm.

Objectives:

By the end of this simulation-based session, the learner will be able to: 1) Recognize the signs and symptoms of thyroid storm and appropriately diagnose a patient with thyroid storm. 2) Choose appropriate medications for the treatment of thyroid storm. 3) Determine the appropriate disposition for a patient presenting in thyroid storm. 4) Discuss the rationale behind each drug used to treat thyroid storm. 5) List at least three precipitants of thyroid storm.

Method:

This case can be run as a low, medium, or high-fidelity simulation.

Topics:

Thyroid storm, thyrotoxicosis, hyperthyroidism, endocrine emergencies.

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