- Osmolality >350 mOsm/kg
- Sodium >160 mmol/L
- Glasgow Coma Scale (GCS) <12
- SpO2 <92% on RA
- Systolic BP <90 mmHg
- Hypothermia
- Urine output <0.5ml/kg/hr
- Macrovascular events such as MI or stroke
Following initial assessment, the patient’s serum sodium is measured at 162 mmol/L and his GCS starts to fall and he is more confused and drowsy (E2,V4,M5). A CT head is requested and reported as ‘normal’.
Given the severity of HHS it is agreed to monitor the patient in HDU for management and gentle correction of the biochemical abnormalities.
