Hospital-Acquired Hyponatremia, and Use of Hypertonic 3% Saline in Adults

Hyponatremia has been estimated to occur in 15-30% of patients hospitalized acutely or chronically, and is cited as the most common electrolyte disorder encountered in clinical practice.^1,2 It can be life-threatening.

Our previous bulletins have discussed the need for standardized protocols governing the safe management of hyponatremia. (see below).

Hypertonic saline is sometimes used in the management of severe hyponatremia and the use of guidelines for its safe utilization and storage are suggested.

This web page provides health care professionals with useful resources and information on this topic.

Published Resources
- Resources from literature on identifying, managing and monitoring hyponatremia
Hospital Resources
- Example guidelines for management of hyponatremia
- Example IV monographs for 3% hypertonic saline
ISMP Canada Resources
- Safety Bulletins
- Webinars

References:

Upadhyay A, Jaber BL, Madias NE. Incidence and prevalence of hyponatremia. Am J Med. 2006; 119:S30-35.
Spasovski G, Vanholder R, Allolio B, et al. Clinical practice guideline on diagnosis and treatment of hyponatremia. Eur J Endocrinol. 2014; 170(3):G1-47.

The Hospital-Acquired Hyponatremia Knowledge Exchange was developed for the purpose of sharing useful resources and information on this topic. Our collaborative goal is to support implementation of protocols, preventative strategies and system safeguards to decrease the risk for medication errors and to promote medication safety. To contribute documents and change management-related information to this site, email us at info@ismp-canada.org or phone us at 416-733-3131 (or toll free 1-866-544-7672).

All reasonable precautions have been taken by the Institute for Safe Medication Practices Canada (ISMP Canada) to verify the information contained in this website. However, ISMP Canada does not guarantee the quality, accuracy, completeness or timeliness of such information. Accordingly, the information is shared without warranty or representation of any kind (express, implied or statutory). The responsibility for the interpretation and use of the information provided hereby lies with the reader. In no event shall ISMP Canada be liable for damages arising from the use or misuse of such information.