A 78-year-old man is brought to the emergency department with confusion and seizures. Serum sodium is 108 mmol/L. Symptoms began within the last 12 ho...

Question

A 78-year-old man is brought to the emergency department with confusion and seizures. Serum sodium is 108 mmol/L. Symptoms began within the last 12 hours. What is the most appropriate initial management of his hyponatraemia?

Accepted Answer

Administer 100 mL boluses of 3% saline to raise serum sodium by 4-6 mmol/L, with close monitoring

Answer

Fluid restriction alone

Answer

Rapid correction with hypertonic saline aiming to normalise sodium within 6 hours

Answer

Administer isotonic 0.9% saline at 30 mL/kg over 1 hour

Answer

No treatment; the seizures will self-resolve

ca-mccqe1 MCQ (SBA): Acute severe hyponatraemia

A 78-year-old man is brought to the emergency department with confusion and seizures. Serum sodium is 108 mmol/L. Symptoms began within the last 12 hours. What is the most appropriate initial management of his hyponatraemia?