A 36-year-old female complains of palpitations. She tells you that she has a hyperactive thyroid gland. Her skin is warm and moist. Her vital signs are P 108 and irregular, R 18, BP 126/80, and SpO2 is 97% on room air. You should:

• A. Transport her.
• B. Cool her.
• C. Administer oxygen by non-rebreather mask.
• D. Administer oxygen by nasal cannula.

Answer: (A)

A stable tachyarrhythmia in a patient with signs of hyperthyroidism requires rapid transport to a facility where ECG, thyroid function tests, and appropriate rate control can be evaluated and started if needed. Her pulse is fast and irregular, which fits atrial fibrillation with rapid ventricular response that hyperthyroidism can provoke. Yet she is hemodynamically stable (normal BP, good oxygen saturation, no distress), so there’s no need for in-field interventions like cooling or high-flow oxygen. In the hospital, clinicians can assess for thyroid storm or other complications and manage the rhythm appropriately, often with beta-blockade to control rate and treat thyrotoxic effects, along with definitive thyroid treatment. If instability or hypoxia develops, the approach would change, but for now the priority is timely transport for definitive care.