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Treatment of mild EAH
Observation (restrict hypotonic and isotonic fluids until urinating freely)
Administration of intravenous HTS ( see below for severe symptomatology )
Administration of oral HTS:
▸ Concentrated bouillon (4 bouillon cubes in 125 mL, ½ cup of water)
▸ 3% NaCl (100 mL), preferably with the addition of a flavouring (eg, Crystal Light, Kool Aid)
▸ Equivalent volumes of other solutions of high sodium concentration (eg, 3–9%)
Treatment of severe EAH
Administration of intravenous HTS:
▸ 100 mL bolus of 3% NaCl, repeated twice if there is no clinical improvement ( 10 min intervals have been recommended, but this should be determined by the clinical judgement of the treating physician )
▸ Comparable amounts of more concentrated Na + -containing solutions (eg, 10 mL of 20% NaCl; 50 mL of 8.4% NaHCO 3 ) may be used as an alternative to 3% NaCl .
▸ In some situations ( ie, more severe encephalopathic symptomatology such as seizures, coma or signs of impending brain herniation ) , it may be appropriate to administer larger HTS boluses initially rather than waiting to assess clinical improvement after repeated smaller boluses .
HTS represents hypertonic saline.