Draw serum for T4, TSH, and cortisol. |
Administer levothyroxine 200 to 400 mcg intravenously, followed by daily doses of 50 to 100 mcg, and triiodothyronine 5 to 20 mcg intravenously, followed by 2.5 to 10 mcg every eight hours.* |
Change to an appropriate oral dose of levothyroxine when the patient can tolerate oral medications. (Oral dose is approximately the intravenous dose divided by 0.75). |
Hydrocortisone 100 mg intravenously every eight hours until exclusion of possible adrenal insufficiency. |
Supportive measures: |
Mechanical ventilation |
Fluids and vasopressor drugs to correct hypotension |
Passive rewarming |
Intravenous dextrose |
Consider empirical antibiotic treatment |
Monitor for arrhythmias and treat when indicated |
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