Looking at this a different way we have circulated 5 cases to Consultant Physicians [n=~30] in 2 Trusts asking them to decide on cause and treatment of hyponatraemia. We got an amazing variation in approach and some completely wrong, some lethal advice. While this is no doubt the result of "paper cases", I would hope for better if faced with a live patient, we have two cases, both fatal, which were the result of gross mismanagement of fluid & electrolyte disorders.
Our conclusion, supported by the Dept Medicine was that intervention and timeous advice from the Duty Biochemist was essential.
Ian Watson
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