Suboptimal care in a case of severe hyponatremia in an elderly male patient in the emergency department. A three-question guide for basic assessment and treatment of hyponatremia

Hyponatremia is a common medical disorder with high mortality and morbidity. Extensive guidelines are developed by internal medicine and critical care specialists. However, every physician should be familiar with initial assessment and treatment of hyponatremia. A case of a severe hyponatremia presenting to an emergency room is described where care was suboptimal. This case illustrates that diagnosis and treatment are not always straight forward. Three questions are proposed to guide physicians in the immediate care of hyponatremic patients.