Welcome to Season 3 of TheNewlyMeds! Today starts with a classic “not acting like herself” call that looks like sepsis, until it isn’t. Dan and Wil break down the endocrine emergencies EMS can miss when we anchor on infection.
We cover thyroid and adrenal crises that can silently worsen, then crash fast: Graves and thyrotoxicosis, thyroid storm, apathetic hyperthyroidism in older adults, myxedema coma, Addison’s disease and adrenal crisis, plus Cushing syndrome. You’ll get practical prehospital recognition tips you can use without labs, along with what matters most in the field: airway, temperature, rhythms, glucose, fluids, and key pitfalls to avoid.
Quick pattern recap: too fast and too hot: thyroid excess. too slow with hypoventilation: thyroid failure. shocky and refractory: adrenal failure.
Whether you’re a new paramedic, an EMT, or just someone who loves learning from the streets, this is a must-listen reminder that the only real mistake in medicine is not learning from the ones you make! As always, this podcast does not contain medical guidelines or protocols, please refer to your statewide scope of practice and accepted protocols and procedures for your level of licensure. TheNewlyMeds podcast has no agency affiliation and is an independently owned and operated podcast
References:
Myxedema crisis (2024 Chen et al.):
https://journals.sagepub.com/doi/full/10.1089/thy.2023.0559
Thyroid storm (2024 Elendu et al.):
https://pmc.ncbi.nlm.nih.gov/articles/PMC10977538/
Addison’s disease (2023 Carsote et al.):
https://pmc.ncbi.nlm.nih.gov/articles/PMC10243343/
Graves disease (2022 Hoang et al.):
https://pmc.ncbi.nlm.nih.gov/articles/PMC9174594/
Cushing’s syndrome (2025 Dillon et al.):
https://pmc.ncbi.nlm.nih.gov/articles/PMC12484323/
Adrenal crisis (2022 Lentz et al.):
https://www.sciencedirect.com/science/article/abs/pii/S0736467922003481
Apathetic thyrotoxicosis (2023 Lee et al.):
https://pmc.ncbi.nlm.nih.gov/articles/PMC10873132/
https://pmc.ncbi.nlm.nih.gov/articles/PMC9627317/