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.