A 43-year-old has a generalised seizure and reduced consciousness. Serum sodium is 108 mmol/L and glucose is normal; there is no evidence of hypovolae...

Question

A 43-year-old has a generalised seizure and reduced consciousness. Serum sodium is 108 mmol/L and glucose is normal; there is no evidence of hypovolaemic shock. What is the immediate sodium-directed treatment?

Accepted Answer

Give 150 mL 3% saline boluses with frequent sodium reassessment

Answer

Infuse 0.9% saline continuously to normalise sodium within six hours

Answer

Give intravenous furosemide and replace urinary sodium losses hourly

Answer

Restrict fluid and recheck serum sodium after the seizure has stopped

Answer

Infuse 1.8% saline continuously until serum sodium reaches 135 mmol/L

NSTEMI — MRCEM SBA MCQ

A 43-year-old has a generalised seizure and reduced consciousness. Serum sodium is 108 mmol/L and glucose is normal; there is no evidence of hypovolaemic shock. What is the immediate sodium-directed treatment?