In a patient presenting with signs of thyrotoxicosis in the field, the most appropriate action is to:

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

Answer: (D)

In thyrotoxicosis or a potential thyroid storm, the priority in the field is rapid transport to a facility where definitive treatment can begin. The body's sympathetic surge can lead to life-threatening complications, so getting the patient to an ED promptly is the most important action. In the field you should provide basic stabilization—protect the airway, monitor breathing, and give oxygen if there’s hypoxia or difficulty breathing—but delaying transport to perform cooling or medication dosing is not beneficial. Definitive therapy requires hospital-based treatment (beta-blockade to control adrenergic symptoms, antithyroid drugs, iodine after antithyroid therapy, steroids, fluids, and careful monitoring). So the best action is to transport her now while continuing supportive care.