Best Case Ever 33: Over-correction of Hyponatremia

In the upcoming episode on Managment of Hyponatremia, Dr. Baimel and the first ever Internal Medicine specialist on EM Cases, Dr. Ed Etchells, discuss a rational step-wise approach to managing Hyponatremia, tailored for the EM practitioner; when you might consider giving DDAVP in the ED, the best way to correct Hyponatremia, how to manage the patient who’s Hyponatremia has been corrected too quickly, and an easy approach to the differential diagnosis. Get a sneak peak at the algorithm that will be explain and review in the upcoming episode……

Published February 2015

Step-Wise Approach to Hyponatremia and Prevention of Over-correction of Hyponatremia

Conceived by Dr. Edward Etchells, Sunnybrook Health Sciences Centre, Toronto, Canada

over-correction of hyponatremia

Dr. Helman & Dr. Etchells have no conflict of interest to declare

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About the Author:

Dr. Anton Helman is an Emergency Physician at North York General in Toronto. He is an Assistant Professor at the University of Toronto, Division of Emergency Medicine and the Education Innovation Lead at the Schwartz-Reisman Emergency Medicine Instititute. He is the founder, editor-in-chief and host of Emergency Medicine Cases.


  1. Rachel Shemtov August 6, 2015 at 9:52 pm - Reply

    Great overview. Very informative with regard to ddavp. Our ER doesn’t do stat urine lytes/osms but will closely monitor urine output. Thanks!

  2. Diego Peñailillo Güenante November 14, 2015 at 8:21 am - Reply

    This is an amazing podcast. I was hearing about the management of hyponatremia and it was an excellent guide, very clear and informative.
    About urine osm/electrolytes in ER, there shouldn’t be any issue in labs, because the very same machine that does plasma electrolytes is the one that does the urinary ones (as a nephrologist once told me).

    Greetings from Chile!

  3. Dr Aman B P Gaonkar June 26, 2017 at 8:00 am - Reply

    Excellent podcast with nice practical points.
    I just want to get clarified about Osmotic Demyelination Syndrome. Does it occur after overcorrection even if Hyponatremia is of acute onset?

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