Regulatory: Thyroid storm
Risks
pathology/etiology
Treatment
labs/diagnostics
untreated hyperthyroidism or interruption in medical regimen
thyroid surgeries or heavy manipulation of the thyroid gland during surgery
Grave's disease
contrast dyes
S&S
complications
S&S hyperthyroid: heat intolerance, diaphoresis, weakness
GI: N&V, diarrhea
CNS: agitation/irritability, delirium, coma
hyperthermia
CV: tachycardia, dysrhythmias, HTN
Death
organ damage
Heart failure
dyspnea
cooling measures
treatment of underlying factors (infection, DKA, hyperthyroidism)
Pharm: admin of thionamides, iodine compounds, beta-blockers, glucocorticoids, antipyretics
Fluid replacement
t3/t4 and TSH levels
metabolic panel, CDC, LFT, creatinine/BUN
blood glucose
radioactive iodine uptake test
TS occurs from excessive release of t3/t4 from the thyroid gland often caused by untreated/undertreated grave's disease/hyperthyroidism. It is often precipitated by increased stress, infection and DKA. Alternatively excessive manipulation of the thyroid can also cause TS.
T3/T4 regulates the body's metabolism. When excessive amounts are released cellular metabolism drastically increases resulting in depletion of the bodies energy reserves (causing weakness) and hyperthermia (causing dehydration/diaphoresis). The increased metabolism also increases O2 demands throughout the body causing air dyspnea/air hunger. Excessive amounts also stimulates the SNS leading to extreme tachycardia eventually causing high-output heart failure and dysrhythmias. As perfusion, oxygenation and bodily reserves fail, coupled with hyperthermia, cell death occurs resulting in organ failure and death.