Acute management of hyponatraemia

Acute management of hyponatraemia

STARTFINISHCreated with SnapCHECKNeurosurgery,transplant, hepaticfailure patient? Seerelevant specialtyguidelinesNOYESSTARTFINISHCreated with SnapNew Serum Na<130Is hyponatraemia dueto severehyperglycaemia?YESNOSTARTFINISHCreated with SnapClarify SeverityIs Sodium <125 WITHsymptoms?Click link for criteriaSTARTFINISHCreated with SnapGet urgent senior helpA to E assess,wide-bore IV access,Catheter and hourlyUO,Consider ICU/HDUSTARTFINISHCreated with SnapTreat low NaConsider hypertonicsaline (click link)Consider endocrinereviewSTARTFINISHCreated with SnapInitial IxUrine Na + osmo,serum U+E + osmo,TFTs, am cortisolCHECK MEDs (link)NODEFICITOVERLOADSTARTFINISHCreated with SnapAssess Fluid StatusIs there clearevidence of fluiddeficit or overload? Ifunsure, seek seniorreview...STARTFINISHCreated with SnapAwait investigationand senior reviewSTARTFINISHCreated with SnapRehydration with 0.9%NaCl or plasmalyteSTARTFINISHCreated with SnapMonitorU+Es - considerclinical picture,biochemical severityand risk of ODS (clicklink for info)STARTFINISHCreated with SnapIdentify and Treat...See information onlinkConsider endocrinereview as requiredSTARTFINISHCreated with SnapOptimise underlyingvolume overload statee.g. fluidrestriction/loopdiuretic/HASSTARTFINISHTreat underlyinghyperglycaemicdisorder(correct sodium forglucose if significant...