Best of Five 3.38

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BOF: 3.38

A 75-year-old female has been admitted as an emergency having been found collapsed on the floor at home. She is known to have hypothyroidism but the bottle of tablets found by the ambulance crew appears unopened.

On examination she is drowsy, has a core temperature of 30^oC. Her pulse rate is 40 beats per minute and blood pressure 90/60. There are fine inspiratory crepitations at the left base of her lungs.

ECG shows sinus bradycardia with low voltage complexes.

In this patient your most important course of action would be:

a)      Rapid infusion of intravenous saline

b)      Bolus of 50 % dextrose 50 mls intravenously

c)      Rapid external rewarming

d)      Intravenous broad spectrum antibiotics after taking blood cultures

e)      Intravenous thyroxine

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