🌡️ Thyroid Storm Recognition & Management (BWPS)
UseUse when thyrotoxicosis is severe: a BWPS ≥ 45 suggests storm, 25–44 is impending, and < 25 is unsupportive —…
SourceRoss DS, et al. 2016 ATA Guidelines for Diagnosis and Management of Hyperthyroidism (thyroid storm)…
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
(original synthesis · not guideline verbatim)
When to use
Use when thyrotoxicosis is severe: a BWPS ≥ 45 suggests storm, 25–44 is impending, and < 25 is unsupportive — but treatment is driven by clinical judgment, not by waiting for a threshold.
How it works
BWPS sums temperature, heart rate, atrial fibrillation, heart failure, CNS, GI-hepatic, and precipitant points. → iodine → glucocorticoid → β-blocker → supportive care; plasma exchange if refractory.
Key points
- (original synthesis · not guideline verbatim)
- Glucocorticoids both treat the storm and guard against concurrent adrenal crisis.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Temperature | 38.3–38.8°C |
|---|---|
| Heart rate (bpm) | 110–119 |
| Atrial fibrillation | No |
| Congestive heart failure | Mild (pedal edema) |
| Central nervous system | Mild (agitation) |
| GI-hepatic | Moderate (diarrhea/nausea-vomiting/abdominal pain) |
| Precipitant | None |
→BWPS score50pts
- Decision：Suggestive of thyroid storm (< 25 unsupportive / 25–44 impending / ≥ 45 storm)
- Management：(5) cooling (avoid aspirin), fluids, correct electrolytes, sedation, treat precipitant (e.g. infection); if refractory → plasma exchange
- Key point：Iodine must be given after ATD, otherwise it may worsen; glucocorticoid also guards against adrenal crisis
| Temperature | < 37.2°C |
|---|---|
| Heart rate (bpm) | < 99 |
| Atrial fibrillation | No |
| Congestive heart failure | None |
| Central nervous system | None |
| GI-hepatic | None |
| Precipitant | None |
→BWPS score0pts
- Decision：Does not support thyroid storm (< 25 unsupportive / 25–44 impending / ≥ 45 storm)
- Management：Below the storm threshold: manage as hyperthyroidism/thyrotoxicosis per protocol with close monitoring, watching for progression to storm; actively remove/treat precipitants
- Key point：Iodine must be given after ATD, otherwise it may worsen; glucocorticoid also guards against adrenal crisis
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using Thyroid Storm Recognition & Management (BWPS)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does Thyroid Storm Recognition & Management (BWPS) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is Thyroid Storm Recognition & Management (BWPS) calculated in practice? Can you show a worked example?
- Inputs: Temperature 38.3–38.8°C, Heart rate (bpm) 110–119, Atrial fibrillation No, Congestive heart failure Mild (pedal edema), Central nervous system Mild (agitation), GI-hepatic Moderate (diarrhea/nausea-vomiting/abdominal pain), Precipitant None → Result: BWPS score 50 pts（Decision: Suggestive of thyroid storm (< 25 unsupportive / 25–44 impending / ≥ 45 storm), Management: (5) cooling (avoid aspirin), fluids, correct electrolytes, sedation, treat precipitant (e.g. infection); if refractory → plasma exchange, Key point: Iodine must be given after ATD, otherwise it may worsen; glucocorticoid also guards against adrenal crisis） Inputs: Temperature < 37.2°C, Heart rate (bpm) < 99, Atrial fibrillation No, Congestive heart failure None, Central nervous system None, GI-hepatic None, Precipitant None → Result: BWPS score 0 pts（Decision: Does not support thyroid storm (< 25 unsupportive / 25–44 impending / ≥ 45 storm), Management: Below the storm threshold: manage as hyperthyroidism/thyrotoxicosis per protocol with close monitoring, watching for progression to storm; actively remove/treat precipitants, Key point: Iodine must be given after ATD, otherwise it may worsen; glucocorticoid also guards against adrenal crisis）