Sodium Disorders

In this episode, Sam Ashoo, MD and T.R. Eckler, MD discuss the April 2025 Emergency Medicine Practice article, Sodium Disorders in the Emergency Department: A Review of Hypernatremia and Hyponatremia

Hypernatremia (High Sodium Levels) Definition: Sodium level greater than 145 mEq/L Breakdown into three categories based on total body water status Hypovolemic Hypernatremia Euvolemic Hypernatremia Hypervolemic Hypernatremia Common causes and conditions associated

Hyponatremia (Low Sodium Levels) Definitions: Mild (130-135 mEq/L), Moderate (125-129 mEq/L), Profound (< 125 mEq/L) Breakdown into three categories Pseudo Hyponatremia Hypovolemic Hyponatremia Euvolemic Hyponatremia Hypervolemic Hyponatremia Common causes and conditions associated

Treatment Guidelines and Strategies Emphasizing slow correction to avoid complications like cerebral edema and osmotic demyelination syndrome Suggested treatment rates for acute and chronic conditions

Special Considerations Addressing severe cases and the importance of proper diagnostics Pre-hospital care considerations and scenarios Pediatrics and consideration of child abuse in sodium disorders

Five Things That Will Change Your Practice Central lab sodium values over point-of-care for accuracy Rectal temperature checks in endurance athletes Loop diuretics for hypervolemic hyponatremia (e.g., CHF patients) Enteral treatment for hypernatremia, if possible Considering COVID-19 as a possible cause for new onset SIADH