A 63-year-old female with a history of hypothyroidism presents in a stuporous state, responsive only to pain. Physical exam reveals thin hair, a puffy face, an enlarged tongue, and cold, doughy skin. Her heart rate is 70 and regular, RR is 10 and regular, BP is 90/62, blood glucose level is 60 mg/dL, and temperature is 86°F via a tympanic thermometer. Your treatment of this patient should NOT include:

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This patient is presenting with signs of myxedema coma, a severe form of hypothyroidism. Active rewarming is not recommended in the initial management of myxedema coma due to the risk of vasodilation and hypotension, which can worsen the patient's condition. Instead, management focuses on supportive care, including airway protection (endotracheal intubation if necessary), administration of IV thyroid hormone, and correction of hypoglycemia (with IV dextrose) and hypotension (with IV fluids).

A 63-Year-Old Female with a History of Hypothyroidism Presents in a Stuporous