Emergency Medicine Cases Episode 60: Emergency Management of Hyponatremia
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Mar 3, 2015 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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Resuscitation in Hyponatremia
- Prioritize hemodynamic instability over concerns about rapid sodium correction.
- Give a small fluid bolus, and consider Ringer's Lactate over normal saline for resuscitation.
Hyponatremia Symptoms
- Hyponatremia symptoms depend on severity and how quickly it develops.
- Acute hyponatremia presents with more severe neurological symptoms due to cerebral edema.
Hypovolemia and Hyponatremia
- Hypovolemia itself doesn't cause hyponatremia; it's the continued water intake with impaired excretion.
- A hypovolemic patient's kidneys can't filter water effectively, leading to hyponatremia when they drink more.