Episode 223: Thyroid Storm

Episode 223: Thyroid Storm

From Core EM - Emergency Medicine Podcast by Core EM

May 15, 2026 · 9 min · Episode 223

About this episode

This episode covers the diagnosis, workup, and treatment protocol for thyroid storm.

Diagnosis, workup, and the four-step treatment protocol for thyroid storm. Hosts: Annaliese Elam, MD Brian Gilberti, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Thyroid_Storm.mp3 Download Leave a Comment Tags: Critica Care , Endocrine , Thyroid Storm Show Notes I. Pathophysiology & Diagnosis Definition: Life-threatening hypermetabolic state resulting from decompensated thyrotoxicosis. Hormonal Profile: Absolute levels of total T₄/T₃ often mirror uncomplicated thyrotoxicosis; storm is driven by rapid rate of rise, increased catecholamine sensitivity, or increased free T₄/T₃ concentrations. Clinical Presentation: Hyperpyrexia (e.g., 104.2°F) Tachycardia/Arrhythmias (e.g., 155 bpm) Altered Mentation: Agitation, delirium, or psychosis; often the primary differentiator between “storm” and “compensated” hyperthyroidism Warm, moist skin Precipitating Events: Infection, trauma, or surgery Parturition Abrupt cessation of antithyroid medications Burch-Wartofsky Point Scale (BWPS) : ≥ 45: Highly suggestive of Thyroid Storm 25–44: Suggestive of impending storm < 25: Storm unlikely Note: High sensitivity but low specificity; can be skewed by…

People in this episode

Hosts: Annaliese Elam, MD, Brian Gilberti, MD

Topics covered

  • Thyroid Storm
  • Diagnosis
  • Treatment Protocol
  • Hyperthyroidism
  • Critical Care

Keywords

  • Thyroid Storm
  • Diagnosis
  • Treatment
  • Hypermetabolic state
  • Thyrotoxicosis

Mentioned in this episode

Books & works: Thyroid Storm

More episodes of Core EM - Emergency Medicine Podcast

Explore listener stats, chart rankings, contacts and more on the Core EM - Emergency Medicine Podcast podcast page.