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EM Clerkship

Hyponatremia (Deep Dive R25)

EM Clerkship

Zack Olson, MD ; Mike Estephan, MD ; Maddie Watts, MD

Health & Fitness, Science, Education, Medicine, Life Sciences

4.9 β€’ 816 Ratings

πŸ—“οΈ 15 September 2021

⏱️ 12 minutes

🧾️ Download transcript

Summary


Hyponatremia in the ED



Four questions to ask yourself:



* Is the patient symptomatic from their hyponatremia (confusion, nausea/vomiting, ams, seizures, etc)?* If not, outpatient followup (unless super low)* Is the patient having severe neurologic symptoms from their hyponatremia? (seizures, AMS)* If yes, treat with hypertonic saline (3%)* Is the patient going to be admitted from their hyponatremia?* If yes, obtain serum osmolarity to rule out pseudohyponatremia* Is the patient dehydrated/hypovolemic?* If yes, treat with NS bolus* If euvolemic/hypervolemic, treat with fluid restriction



Further Reading:



EMCrit – Hyponatremia



EMDocs – Critical Hyponatremia




Transcript

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0:00.0

Hello, everybody.

0:02.1

Thank you for downloading this month's deep dive.

0:06.8

This episode is sponsored by Pearson Ravits Insurance.

0:10.8

Stephanie Pearson at Pearson Ravits is my personal disability and life insurance agent.

0:15.5

It is my personal opinion that a solid individual disability insurance policy is a purchase that you should be making

0:23.0

during residency. And the reason for this being is that you can get that underwriting done

0:28.2

early while you're healthy and before you have some sort of injury or other medical diagnosis

0:34.2

that a doctor documents somewhere. Keep in mind that just because you're purchasing

0:40.9

it as a resident, that doesn't mean you need to purchase the full disability insurance amount

0:47.1

that you're going to have as an attending. So let's say as an attending, you're going to want to

0:50.2

buy a disability insurance policy that pays you whatever, $5,000, $7,500 a month,

0:57.1

or whatever it is if you get disabled just because you're going to want that eventually.

1:02.2

That does not mean you have to pay for a policy that big as a resident.

1:06.4

And based off my discussions with Dr. Pearson, in some cases you can buy a policy that pays you

1:11.0

as low as $1,000 a month as a resident if you get disabled.

1:16.2

But what it allows you to do is get all of your underwriting done while you're healthy.

1:20.0

Now, every situation is different.

1:21.8

That is why you need a good disability insurance agent.

1:25.2

Stephanie Pearson at Pearson-Ravits has been my agent

1:27.9

well before we ever had a sponsorship,

1:31.0

kind of partnership going on.

1:32.7

She's a great, great disability insurance agent.

...

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