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Symptomatic hyponatraemia – hypertonic saline — RACP Paediatrics MCQ

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HardNephrologySymptomatic hyponatraemia – hypertonic salineRACP Paediatrics

The same child develops a seizure attributed to hyponatraemia (Na now 118 mmol/L). What is the most appropriate immediate intervention?

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Correct answer: A — Hypertonic saline (3%)

Symptomatic hyponatraemia (seizures) requires urgent 3% hypertonic saline (2-3 mL/kg over 10-15 minutes). Target: raise Na by 4-6 mmol/L acutely to control symptoms. Total correction should not exceed 8-10 mmol/L in 24 hours to prevent osmotic demyelination syndrome.

Reference: RCH Melbourne – 2023 – Hyponatraemia CPG; RACP Paediatric Curriculum – Nephrology