Management of Hyponatraemia - Flowchart

Management of Hyponatraemia - Flowchart

Management of Hyponatraemia - Flowchart Management of Hyponatraemia Management of Hyponatraemia

Flowchart

Hyponatraemia (Tables 85.2)

Hyponatraemia (Tables 85.2)

Hyponatraemia (Tables 85.2)

85.2

End

End

End

Check electrolytes, creatinine/eGFR and glucose, urine/plasma osmolality and spot urine sodium

Check electrolytes, creatinine/eGFR and glucose, urine/plasma osmolality and spot urine sodium

Check electrolytes, creatinine/eGFR and glucose, urine/plasma osmolality and spot urine sodium

Stabilize airway, breathing and circulation
Treat fits
Correct hyponatremia with IV hypertonic saline

Stabilize airway, breathing and circulation
Treat fits
Correct hyponatremia with IV hypertonic saline

Stabilize airway, breathing and circulation
Treat fits
Correct hyponatremia with IV hypertonic saline

Is hyponatraemia due to severe hyperglycaemia?

Is hyponatraemia due to severe hyperglycaemia?

Is hyponatraemia due to severe hyperglycaemia?

Yes

Yes

Yes

No

No

No

Treat hyperglycaemia (Chapter 83)

Treat hyperglycaemia (Chapter 83)

Treat hyperglycaemia (Chapter 83)

Is plasma sodium < 125 mmol/L and causing fits, respiratory failure or reduced conscious level?

Is plasma sodium < 125 mmol/L and causing fits, respiratory failure or reduced conscious level?

Is plasma sodium < 125 mmol/L and causing fits, respiratory failure or reduced conscious level?

Yes

Yes

Yes

No

No

No

Fluid restriction
Identify/treat cause

Fluid restriction
Identify/treat cause

Fluid restriction
Identify/treat cause

Fluid restriction
Identify/treat cause

Fluid restriction
Identify/treat cause

Fluid restriction
Identify/treat cause

IV saline
Stop diuretic and/ACEi/ARB

IV saline
Stop diuretic and/ACEi/ARB

IV saline
Stop diuretic and/ACEi/ARB

Volume status (Box 85.2)?

Volume status (Box 85.2)?

Volume status (Box 85.2)?

Hypovolaemia

Hypovolaemia

Hypovolaemia

Normovolaemia

Normovolaemia

Normovolaemia

Oedema

Oedema

Oedema