you are admitting a patient who has presented in the emergency room course hero

by Prof. Kendrick Lowe Sr. 10 min read

What is myxedema coma?

In the absence of identified hypothyroidism, myxedema coma is a diagnosis of exclusion when all other sources of coma have been ruled out. If myxedema coma is suspected, evaluation of thyroid-stimulating hormone (TSH), free thyroxine (T4), and serum cortisol is warranted. T4 will be extremely low.

Why is cortisol low?

Cortisol may be low indicating adrenal insufficiency because of hypothyroidism. [4] Prognosis:Myxedema coma is a medical emergency. With proper and rapid diagnosis and initiation of therapy, the mortality rate is still as high as 25% to 50%.

Does ketamine cause hypotension?

Ketamine is a sympathomimetic medication and usually does not cause hypotension as all other sedatives do. The patient was ventilated with AC mode of ventilation, tidal volume of 6 ml/kg ideal body weight, flow 70, initial fio2 100 %, rate 26 per minute (to compensate for metabolic acidosis), PEEP of 8. Cardiovascular.