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Dr. Melanie Baimel and Dr. Ed Etchells discuss the emergency management of hyponatremia, including assessing and treating neurologic emergencies, defending intravascular volume, preventing exacerbation, and ascertaining the cause. They answer questions about giving DDAVP, determining the cause, correcting hyponatremia, fluid resuscitation, managing marathon runners, and minimizing the risk of Osmotic Demyelination Syndrome (ODS) and cerebral edema.
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Quick takeaways
- Assess and treat neurologic emergencies related to hyponatremia with hypertonic saline.
- Defend the intravascular volume.
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Maintaining Adequate Intravascular Volume and Preventing Worsening Hyponatremia
In managing hyponatremia, it is important to assess the patient's volume status and provide appropriate fluid resuscitation if they are hypovolemic. In the case of hypervolemia or euvolemia, fluid restriction is recommended to prevent worsening hyponatremia. The use of normal saline or ringers lactate is preferred over hypotonic fluids to avoid rapid overcorrection of sodium levels. Monitoring postural vital signs can help determine the need for fluid boluses.
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