| 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 |
