Myxedema Crisis

# Myxedema Crisis
Patient with*** history of hypothyroidism who presents with altered mental status, hypothermia, and bradycardia, concerning for myxedema crisis. DDx includes ***.
Dx
- CBC, CMP, Free T4, TSH, cortisol, lactate
- CXR, BCx x2, UA, Utox
- Na, Glucose q2-4h PRN
- EKG
Tx
- Following endo consultation, consider T4 200-400mcg IV, T3 5-20mcg IV, and hydrocortisone 100mg q8h IV
- Consider empiric antibiotics and fluids if concerned for sepsis
- Passive warming, mechanical ventilation, pressors PRN