Further along the spectrum of severity from hypothyroidism:

	↓ level of consciousness, defective thermoregulation and cardiovascular collapse
Etiology	All the things that can cause hypothyroidism including the problematic drugs; surgery, burns, trauma, stroke, sepsis
Clinical presentation	- Hypothermia, bradycardia - Hypoactive delirium - Hypoglycaemia, Hyponatraemia - ↓ gut motility
Pathogenesis
Diagnostic investigations	TSH, fT4 CK (might be high)
Management	Resuscitation: A-E, up to and including invasive ventilation if necessary Address underlying cause: Supplement thyroxine (parenterally?) Stress dose steroids (giving thyroxine without steroids can precipitate adrenal crisis) Correct Na (hypervolaemic) ct Na br>Na

critical care considerations

airway