PODCAST: Hyponatremia in the ED

Four questions to ask yourself:

?Is the patient symptomatic from their hyponatremia (confusion, nausea/vomiting, ams, seizures, etc)

If not, outpatient followup (unless super low)

Is the patient having severe neurologic symptoms from their hyponatremia? (seizures, AMS)

If yes, treat with hypertonic saline (3%)

?Is the patient going to be admitted from their hyponatremia

If yes, obtain serum osmolarity to rule out pseudohyponatremia

?Is the patient dehydrated/hypovolemic

If yes, treat with NS bolus

If euvolemic/hypervolemic, treat with fluid restriction

Further Reading:

EMCrit – Hyponatremia

EMDocs – Critical Hyponatremia

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