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Module IV - Exercise-Associated Hyponatremia

 

Overview

In this module, the individual will learn how to manage episodes of exercise-associated hyponatremia (EAH) on the race course. He/she will learn best-practice guidelines and preventive medical plans for healthcare professionals, as well as definitions, mechanisms, and symptoms of EHS. The final portion of the module introduces the use of algorithms for informed decision-making.


Learning Objectives

By the end of this module, the learner will know how to recognize and manage episodes of EHS during endurance events.

 

Key Pedagogical Points

 
  • EAH is a decrease in blood concentration below 135mmol/L, and can be fatal.
  • EAH is usually caused by over-drinking.
  • Hyponatremic patients require electrolyte monitoring and correction.
  • Blood sodium measurement must be taken before considering an intravenous treatment.
  • In severe cases, intravenous hypertonic saline is the appropriate treatment.
  • Decision on treatment with intravenous hypertonic saline is based on symptoms severity rather than sodium levels.
  • If blood measurement is not available and the signs of an EAH are present, do not administer hypotonic nor normal saline.
  • Communicating fluid intake guidelines to runners and having race organisers make alterations to fluid availability during the event can improve the management of this severe condition.
  • Disseminating fluid intake guidelines to runners and race organisers.
  • Fluid availability plan should be adapted to weather conditions to prevent athletes from over drinking.