Emergency Medicine Board Bombs 240. A Salty Solution: SCARY Hyponatremia
Nov 24, 2024
Dive into the urgent world of severe hyponatremia and learn why it's crucial for emergency medicine professionals. A detailed clinical case study highlights the management of critically low sodium levels and the strategic use of hypertonic saline. Discover signs and complications that can arise, along with the importance of continuous education in this high-stakes field. Perfect for those seeking to enhance their medical knowledge while keeping things engaging!
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Treat Severe Hyponatremia
- Administer 3% hypertonic saline (100 mL bolus over 10 minutes) for patients with severe, symptomatic hyponatremia (sodium < 120).
- Repeat the bolus 2-3 times as needed, aiming for a sodium increase of 4-6 mEq/L in the first six hours.
ED Focus on Hyponatremia
- Hyponatremia is common in hospitalized patients, but ED attention is crucial only when it's severe (<120 mEq/L) or symptomatic.
- Symptoms like seizures, confusion, lethargy, or cerebral edema (headache, vomiting) warrant immediate action.
Assess Hyponatremia
- When evaluating hyponatremia, consider sodium level, presence of cerebral edema symptoms (seizures, confusion, headache), and cause.
- Critical causes include acute sodium drop (e.g., psychogenic polydipsia), SIADH (trauma, malignancy), and adrenal insufficiency.