All right, so welcome back to the Internet Book of Prudicle Care podcast.

I'm here with Adam Thomas, and we're going to talk to you today about hypernatremia.

Josh is going to take us from the amateur level to the skilled pro level.

We're kicking it up a level here because you're an amateur if you don't

follow the sodium, right Josh? Oh, seriously, man. Yes. So today we'll cover why hypernatremia

is important in the ICU. We'll cover those causes of hypernatremia and then we'll move into

the evaluation of how to lock down the cause. Again, as always, big part of the podcast will be treatment,

and then we'll cover specifically what's going on with the elderly patients. So let's move on

into why hypernatremia is so important. What does it speak to me as an intensivist about?

At first, you may think that hypernatremia is kind of boring, but it's actually incredibly important

because this is a very, very common housekeeping problem in the ICU where we don't give our

patients enough free water and they become hypernatremic. And hypernatremia will cause your

patients to be incredibly miserable and it will cause them to be super delirious. Imagine being

intubated, being more thirsty than you've ever been in your entire life and having this warm ET tube stuck in your mouth, you're going to be incredibly agitated

and you're going to end up getting tons of fentanyl and houndall, and it's just going to cause

this spiral of badness.

So realizing that hypernatremia is a huge problem and treating it aggressively is incredibly

important.

You think waterboarding is bad?

What we do to a lot of our patients sounds even worse. So pay attention to the sodium level. Understand that it will worsen delirium,

it will worsen agitation, and will keep your patients in the ICU longer.

So moving on to common causes, not just us, but there's some other causes we need to think

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