Ep 210 Decompensated Hypothyroidism Recognition and Management

About this episode

This episode discusses the recognition and management of decompensated hypothyroidism in emergency medicine.

In the ED, we regularly care for sick patients presenting acutely with abnormal vital signs, altered mental status, and end organ dysfunction. Oftentimes, the culprit ends up being sepsis, or overdose, or organ failure. But it is important that we consider rarer endocrine presentations like decompensated hypothyroidism. In this Part 1 of this two-part podcast with Dr George Willis and Dr Alyssa Louis, we answer questions like: Why is the term myxedema coma a misnomer and should be abandoned? How can we differentiate between sepsis or environmental hypothermia or toxidrome from decompensated hypothyroidism at the bedside? When is it appropriate to order a TSH, a T4 and T3? What are the most important life-threatening triggers that need to be addressed in patients with decompensated hypothyroidism? Why is it important to test for cortisol levels and consider stress-dose steroids in all patients with decompensated hypothyroidism? Why is endotracheal intubation particularly dangerous in decompensated hypothyroidsm? What is the best way to manage hypothermia? Why is the order of medications for treatment of decompensated hypothyroidism so important? and many more... Please consider a…

People in this episode

Host: Dr. Anton Helman

Guests: Dr George Willis, Dr Alyssa Louis

Topics covered

• decompensated hypothyroidism
• emergency medicine
• endocrine disorders
• patient management
• vital signs
• altered mental status

Keywords

• myxedema coma
• TSH
• T4
• T3
• cortisol levels
• stress-dose steroids
• hypothermia
• medication management

Mentioned in this episode

Organizations: EM Cases

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