Ep 211 Thyrotoxicosis and Thyroid Storm: Recognition and Management

In this Part 2 of our 2-part podcast series on thyroid emergencies Anton, Dr. George Willis and Dr. Alyssa Louis answer questions such as: When a patient presents with “sepsis without a source,” what bedside features should trigger you to prioritize thyrotoxicosis? How can PoCUS help you decide whether tachycardia is dangerous — or lifesaving — before starting β-blockade? Why can TSH and free T4 be falsely reassuring in a crashing patient, and what labs actually matter early? In which patients does propranolol increase the risk of cardiovascular collapse — and why is esmolol the safer first line medication? Why does the order β-blocker → thionamide → steroid → iodine matter, and what happens if you get it wrong? When is not giving a β-blocker the safest decision in thyroid storm, even in a profoundly tachycardic patient? In an agitated, hyperthermic patient with thyrotoxicosis, why might intubation be more dangerous than helpful in the first hour? How does amiodarone-induced thyrotoxicosis fundamentally change your management — and why can iodine make it worse? and many more...