Thursday, April 15, 2010

PCL 7- Balancing Act : Scribe

Hazim

Age: 35

Motor vehicle accident-

CT scan shows bleeding in left side of skull

Physical weakness on right side of body

Traumatic brain injury: Recovery of mental function is uncertain

10 days later, Hazim was responsive

Treatment: 1L Normal Saline & 1L 5% dextrose per day

Decreased with plasma sodium

No more response from Hazim: slack and skin pale

Nasogastric tube

Normal biochemistry profile

LEARNING OBJECTIVES

- Definition of Hyponatraemia -irene

- Causes of hyponatraemia (including SIADH)-akmez

- Pathophysiology of hyponatraemia esp. in brain injured patient-hai sherng, meena ( one concentrate on brain injured patient)

- osmolality & osmolarity: hyper, hypo, different types, pathophysiology, tonicity- li tatt, shuhaiba

- Physiology of sodium and water balance; Fluid balance calculation, what happens in brain injured patients?- tin yee

- Clinical findings when sodium is lowà signs and symptoms- alvin

- Investigation: underlying cause of each hyponatraemia- ching mei

- Management & treatment: include inappropriate fluid management- zhi mei

Complications & prognosis- thomas

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