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Clinical Decision-Making Case: Thyroid Storm

Title: Clinical Decision-Making Case: Thyroid Storm
Authors: Cohen, Stephanie; Vempati, Amrita; Lei, Charles; Moss, Hillary; Moadel, Tiffany; Bentley, Suzanne; Stapleton, Stephanie; Roszczynialski, Kelly N.
Source: Journal of Education and Teaching in Emergency Medicine, vol 10, iss 5
Publisher Information: eScholarship, University of California
Publication Year: 2026
Collection: University of California: eScholarship
Subject Terms: Hyperthyroidism; Communication; Clinical Decision-Making Case; Certifying Exam; Thyroid storm; endocrinology
Description: Audience: This clinical decision-making case is intended for all emergency physicians (EP) in training. Introduction: Thyroid storm (TS) is a rare but life-threatening endocrine emergency that represents the most severe form of thyrotoxicosis. If not promptly recognized and appropriately managed, TS carries a mortality rate of up to 25%.¹ However, with timely and aggressive treatment, mortality can be significantly reduced to 1.2–3.6% in the United States.² Due to its rarity and often nonspecific presentation, early diagnosis and intervention in the emergency department are essential to improving patient outcomes. Recognizing its critical nature, the American Board of Emergency Medicine (ABEM) identifies thyroid storm as a core emergency condition that emergency physicians (EPs) must be trained to manage.³ Additionally, recent updates to the ABEM certifying examination emphasize the importance of clinical decision-making and the ability to verbalize diagnostic reasoning and management plans. This case has been designed to help learners practice and demonstrate these skills in the context of a high-stakes, time-sensitive clinical scenario involving thyroid storm. Educational Objectives: By the end of the session, learners will be able to: 1) verbalize key pertinent historical and physical exam findings in a young female patient presenting with altered mental status; 2) formulate a prioritized differential diagnosis based on the history and physical exam; 3) order appropriate diagnostic studies and recognize abnormalities suggesting thyroid storm; 4) describe pathophysiology, management and rationale of sequential pharmacologic therapy in thyroid storm; 5) communicate patient’s medical care and course to family; and 6) review essential disposition actions including consultations and level of care for admission. Educational Methods: We implemented a certifying exam board format case aligned with the ABEM’s updated certifying exam board examination. The case was co-developed by experts in simulation-based education ...
Document Type: article in journal/newspaper
File Description: application/pdf
Language: unknown
Relation: qt1c35h05x; https://escholarship.org/uc/item/1c35h05x; https://escholarship.org/content/qt1c35h05x/qt1c35h05x.pdf
DOI: 10.21980/J8.53003
Availability: https://escholarship.org/uc/item/1c35h05x; https://escholarship.org/content/qt1c35h05x/qt1c35h05x.pdf; https://doi.org/10.21980/J8.53003
Rights: CC-BY
Accession Number: edsbas.1CF62049
Database: BASE