Kashish Sharma
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The health expert informed that sodium levels can drop very rapidly, putting patient’s life at greater risk and also putting doctors in a tight spot when it comes to time of action
There are instances when a patient might go all healthy to an emergency room and might end up getting critically ill. In most cases, it would be wavered off as a case of medical negligence or hospital trying to make some extra numbers. However, there might be real medical situations where such a scenario can be witnessed. Hyponatremia or low sodium levels in the blood is one such condition which in no time can turn into a medical emergency, resulting in serious clinical outcomes such as coma or even death.
Sodium is an electrolyte that plays an important role in regulating water levels in the body. It is an essential element for proper muscle and nerve function. When its levels dip beyond a certain threshold, it might be called a state of hyponatremia and it can manifest itself in symptoms like lethargy, confusion and fatigue.
In clinical terms, the condition might be defined as a serum sodium level lesser than 135 m mol/L and is a frequently encountered situation in many patients admitted to the emergency wards. However, low sodium levels are often a symptom of some underlying condition such as chronic kidney disease, heart disease or people taking diuretics and not a condition in itself. The imbalance is very often seen in the elderly.
Though low sodium levels are a common electrolyte disorder in clinical medicine but the mechanisms leading to it are complex and often cause confusion and misconceptions in physicians dealing with the disorder. The mechanism of the condition is so strongly guided by the underlying cause that unless there is clarity on what has caused the low levels in the first place, it might be difficult for the physician to provide a targeted treatment. This also means that a lot of tests might have to be performed in a small window of time and the healthcare providers will have to come to the cause root of the dip in utmost urgency. In cases of acute hyponatremia, sodium levels can drop rapidly, resulting in potentially dangerous outcomes like brain swelling, coma and death.
Dr Mantosh Kumar, Senior Consultant, Psychiatry (Fortis National Mental Health and Behavioural Sciences) spoke to Healthsite and informed how this medical situation might be often misinterpreted by people outside the medical fraternity.
He said: "It is a common sight to see a patient land in emergency ward with dropping sodium levels. They might seem alright when they come to the hospital. Maybe the condition might not be that bad when they arrive but the levels might be dropping in them rapidly. One cannot judge what's going inside the body just by looking at a person. The attending doctor is now left to consider so many factors that might have caused it. It could be age-related, maybe the person is dehydrated, may be they are on some medication that is interfering with the electrolyte balance and there might be no end to the reasons. So, in a small window of time, we as doctors might have to find the exact cause to provide a targeted treatment. However, the clock might be clicking all this while and it might start showing on the patient. They might start deteriorating."
The health expert informed that sodium levels can drop very rapidly, putting patient's life at greater risk and also putting doctors in a tight spot when it comes to time of action. "The problem was there, it just became obvious with passage of time and when the person was in hospital .It can be a rapid fall. It has nothing to do with place. Time window is short for doctors in this situation. The patient can become very critical, have seizures within no time."