I got reamed on morning handover today.
55F binge EtOH on HCTZ brought in by family with worsening confusion and nausea. Na 106 (and K 2.3 with ECG changes). Transferred to our ED, and by the time I see her, she's gotten 100mls 3%, 2L N/S and a bunch of K. Her serum sodium is 118 at 9 hours. Symptoms had long since resolved. Urine output is starting to pick up over 400 mls in 30 minutes. 2mcgs DDAVP and admit.
Morning rolls around, Na stable at around 115 and K replaced to 3.5 by...
Severe hyponatremia
55F binge EtOH on HCTZ brought in by family with worsening confusion and nausea. Na 106 (and K 2.3 with ECG changes). Transferred to our ED, and by the time I see her, she's gotten 100mls 3%, 2L N/S and a bunch of K. Her serum sodium is 118 at 9 hours. Symptoms had long since resolved. Urine output is starting to pick up over 400 mls in 30 minutes. 2mcgs DDAVP and admit.
Morning rolls around, Na stable at around 115 and K replaced to 3.5 by...
Severe hyponatremia