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b4806b0 | 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 | {
"id": "thyroid-storm",
"title": "Thyroid storm \u2014 multi-drug thyroid blockade and rate control",
"patient_id": "pat-1022",
"encounter_id": "enc-1022",
"role": "Attending Physician",
"objective": "As the attending physician, review TSH, free T4/T3, and vital sign instability, place PTU and IV propranolol for dual blockade and rate control, document the Burch-Wartofsky score, anti-thyroid therapy, rate control rationale, temperature management, and precipitant, then sign the encounter.",
"required_orders": [
"Propylthiouracil oral",
"Propranolol IV"
],
"required_note_elements": [
"Thyroid hormone levels",
"Burch-Wartofsky score",
"Anti-thyroid therapy",
"Beta-blocker rationale",
"Temperature management",
"Precipitating event"
],
"scoring": {
"base_reward": 1.0,
"substeps": {
"order:Propylthiouracil oral": 0.12,
"order:Propranolol IV": 0.12,
"note_element:Thyroid hormone levels": 0.1,
"note_element:Burch-Wartofsky score": 0.11,
"note_element:Anti-thyroid therapy": 0.09,
"note_element:Beta-blocker rationale": 0.08,
"note_element:Temperature management": 0.08,
"note_element:Precipitating event": 0.09,
"encounter_signed": 0.21
}
}
}
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