The video version of this podcast can be found here: · https://youtu.be/j1mnA-jOi1AThis episode makes reference to guidelines produced by North Bristol NHS Trust, Royal United Hospitals Bath NHS Trust and Royal Cornwall Hospitals NHS Trust. The content on this channel reflects my professional interpretation/summary of the guidance and I am in no way affiliated with, employed by or funded/sponsored by them.My name is Fernando Florido and I am a General Practitioner in the United Kingdom. In this episode I go through the guidelines on hyponatraemia produced by North Bristol NHS Trust, Royal United Hospitals Bath NHS Trust and Royal Cornwall Hospitals NHS Trust, focusing on what is relevant to Primary Care only. Other guidance has also been consulted and links to all of them can be found below I am not giving medical advice; this video is intended for health care professionals; it is only my summary and my interpretation of the guidelines and you must use your clinical judgement. There is a podcast version of this and other videos that you can access here: Primary Care guidelines podcast: · Redcircle: https://redcircle.com/shows/primary-care-guidelines· Spotify: https://open.spotify.com/show/5BmqS0Ol16oQ7Kr1WYzupK· Apple podcasts: https://podcasts.apple.com/gb/podcast/primary-care-guidelines/id1608821148 There is a YouTube version of this and other videos that you can access here: · The Practical GP YouTube Channel: https://youtube.com/@practicalgp?si=ecJGF5QCuMLQ6hrk The links to the Hyponatraemia guidelines consulted can be found here:North Bristol NHS Trust · https://www.nbt.nhs.uk/sites/default/files/Hyponatraemia%20in%20Primary%20Care.pdfRoyal United Hospitals Bath:· https://www.ruh.nhs.uk/pathology/documents/clinical_guidelines/PATH-019_hyponatraemia_in_primary_care.pdfRoyal Cornwall Hospitals NHS trust:· https://doclibrary-rcht.cornwall.nhs.uk/DocumentsLibrary/RoyalCornwallHospitalsTrust/Clinical/EndocrineAndDiabetes/ManagementOfHyponatraemiaClinicalGuideline.pdfGreater Glasgow and Clyde:· https://handbook.ggcmedicines.org.uk/media/1099/195-hyponatraemia-flowchart-1-final-200717e.pdfGloucestershire hospitals NHS Trust · https://www.gloshospitals.nhs.uk/media/documents/Hyponatraemia.pdfIntro / outro music: Track: Halfway Through — Broke In Summer [Audio Library Release] · Music provided by Audio Library Plus · Watch: https://youtu.be/aBGk6aJM3IU · Free Download / Stream: https://alplus.io/halfway-through TranscriptIf you are listening to this podcast on YouTube, for a better experience, switch to the video version. The link is in the top right corner of the video and in the episode description.Hello and welcome, I am Fernando, a GP in the UK. Today, we are looking at the further assessment and management of hyponatraemia, I have looked at the guidelines produced by North Bristol NHS Trust, and Royal United Hospitals Bath NHS Trust, as well as other guidance, focusing on what is relevant to Primary Care only. The links to the sources consulted are in the episode description. If you have not already done so, I recommend that you look at the previous episode on hyponatraemia, its classification, clinical presentation, pathophysiology and causes, which will give you a good introduction. Right, without further ado, let’s get started. Let’s have a look at the management of hyponatraemia. · As we have know, acute or severe hyponatraemia can be a medical emergency and we should admit for hospital treatment anyone with either symptoms or severe hyponatraemia, understood to be a sodium below 125. · People with asymptomatic mild hyponatraemia, that is, a sodium of between 130 and 135, can be investigated and initially managed in Primary Care. · But, what do we do with people who are asymptomatic and who have moderate hyponatraemia, that is, a sodium of between 125 and 129? Well, these people need careful assessment because there may be a risk of the sodium falling quickly. So, in these cases, we should seek specialist advice in respect of admission or referral. Let’s now look at the management in Primary Care. And as a precaution, all patients with new onset hyponatraemia should have a repeat sodium checked after one week to exclude a rapidly decreasing level. We should then assess the volume status to see if there is fluid overload or hypovolaemia. We will look at a useful flowchart later which will give us more information in that respect. We should then review the medication and, if it could be the cause, if possible, we will stop it and repeat the sodium levels in 1-2 weeks. If the sodium level remains low after stopping the medication, we should seek specialist advice. Of course, if the medication cannot safely be stopped, then we will discuss with the prescribing consultant....
