12. Red flags and emergency escalation
Any of the following is acted on immediately. EMS is activated first for airway and life threats; provider notification and orders follow.
Red flags — act immediately Stridor, tracheal deviation, or airway compromise → activate EMS. Thyroid storm — high fever, tachycardia or atrial fibrillation, agitation, and confusion → activate EMS (cross-reference Endocrine/Metabolic, Cardiovascular). Myxedema — hypothermia, bradycardia, and obtundation → activate EMS. Post-thyroidectomy expanding neck swelling with difficulty breathing → hematoma with airway compromise — activate EMS. Post-thyroidectomy perioral numbness, tingling, or tetany with positive Chvostek or Trousseau → hypocalcemia; notify urgently for calcium. A rapidly enlarging, hard, or fixed neck mass → evaluate for malignancy; notify. |
|---|