Version June 2024
| For Na level <133 mEq/L or a decrease of 6 mEq/L in 24 to 48 hours: |
| 1. NaCl tabs 3 g PO/NGT every 6 hours |
| 2. Initiate 3 percent NaCl infusion at 20 mL/hour IV |
| 3. Check serum Na every 6 hours |
| a. If Na <130 mEq/L: |
| Increase rate by 20 mL/hour (max rate = 80 mL/hour) |
| If on hold at present, initiate 3 percent NaCl infusion at 20 mL/hour IV |
| b. If Na = 130 to 135 mEq/L: |
| Increase rate by 10 mL/hour (max rate = 80 mL/hour) |
| If on hold at present, initiate 3 percent NaCl infusion at 10 mL/hour IV |
| c. If Na = 136 to 140 mEq/L: |
| No change |
| d. If Na ≥140 mEq/L: |
| Hold infusion |
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