Osmotic Demyelination Syndrome (ODS) and Management of Hyponatremia

In this EM Cases episode Dr. Melanie Baimel and Dr. Ed Etchells discuss a simple and practical step-wise approach to the emergency management of hyponatremia: 1. Assess and treat neurologic emergencies related to hyponatremia with hypertonic saline 2. Defend the intravascular volume 3. Prevent further exacerbation of hyponatremia 4. Prevent rapid overcorrection 5. Ascertain a cause Dr. Etchells and Dr. Baimel answer questions such as: What are the indications for giving DDAVP in the emergency management of hyponatremia? What is a simple and practical approach to determining the cause of hyponatremia in the ED? How fast should we aim to correct hyponatremia? What is the best fluid for resuscitating the patient in shock who has a low serum sodium? Why is the management of the marathon runner with hyponatremia counter-intuitive? What strategies can we employ to minimize the risk of Osmotic Demyelination Syndrome (OSD) and cerebral edema in the emergency management of hyponatremia? and many more...