Thyrotoxic Storm Flashcards
1
Q
what are the signs of thyrotoxic storm?
A
confusion
coma
AF
HF
2
Q
what precipitates a thyrotoxic storm?
A
recent thyroid surgery
radioiodine
MI
infection
3
Q
Plan for Thyrotoxic storm
FRANTIC NELLY BEGAN SHAKING POST DISSECTED ACTIVE THYROID HENCE IN COMA
A
F- Fluids
N –NG tube if vomiting
B – Bloods (TFT + culture if infection suspected)
S – Sedate (chlorpromazine)
P – Propranolol (if CO normal, if low can cause cardiac arrest so give short acting Beta blocker – IV esmolol).
D – Digoxin – to slow heart but ensure B-blockers given.
AT– Antithyroid therapy – Carbimazole + Lugol’s solution (iodine)
H – Hydrocortisone – to prevent conversion of T4 to T3.
I – Infection treat – if underlying infection
C – Continuing treatment – after 10 days stop propranolol + iodine. Adjust carbimazole.
