First 30 seconds
- 1ABCDE + passive rewarming (avoid rapid)
- 2IV access, bloods (TFT, cortisol, glucose, Na, FBC, septic screen)
- 3Glucose if low
- 4Hydrocortisone BEFORE thyroxine
End-stage hypothyroidism with hypothermia, altered mental state, multi-organ decompensation; mortality up to 40%.
A
Airway
- • Patent? Talking? Stridor?
- • Suction, jaw-thrust, adjuncts, definitive airway if needed
B
Breathing
- • RR, SpO₂, auscultate, percuss
- • O₂ to target sats, NIV / intubate as required
C
Circulation
- • HR, BP, cap refill, JVP
- • 2× large-bore IV, bloods, monitor, ECG
D
Disability
- • AVPU/GCS, pupils, glucose, temp
E
Exposure
- • Full exposure, skin, rash, bleeding, lines, infection source
