The Code Tray: The ACCP Emergency Medicine PRN Podcast
Jul 21, 2026 · 16 min · 11 segments
ACCP EM PRN: June 2026 Presenter: Marianna Rieser, PharmD | PGY-2 Emergency Medicine Pharmacy Resident | Memorial Regional Hospital Article: https://onlinelibrary.wiley.com/doi/10.1111/acem.70283…
Marianna RieserGuest
Christian KrollHostCo-HostHost
And regarding disclosure, so I want to acknowledge that this article was originally presented at SAEM at the annual conference in 2025, and it was published in the Journal of Academic Emergency Medicine.
So regarding the study design, this was an objective study which evaluated whether a 50 milliliter bolus of 8.4% sodium bicarbonate produces a serum sodium increase, which is comparable to a 100 ml bolus of 3% hypertonic saline.
And this was a retrospective multicenter cohort study, which was conducted at two hospitals in California between January 2019 and December 2024.
This is primarily a disorder of water balance rather than sodium deficiency.
And it occurs when there is excess body water compared to the total body sodium and potassium.
And so this is most often due to inappropriate vasopressin or antidiuretic hormone activity.
And so the clinical manifestations, that's going to be dependent on the severity of hyponatremia and the rate at which it develops.
We know that in acute hyponatremia, the decrease in serum sodium can result in cerebral edema and severe neurologic complications, whereas chronic hyponatremia often presents with more subtle symptoms, and this is due to cerebral adaption.
Because sodium is the primary determinant of serum osmolality, Rejections in sodium concentrations as well, that promotes water movement into the cells, specifically in the brain.
And regarding disclosure, so I want to acknowledge that this article was originally presented at SAEM at the annual conference in 2025, and it was published in the Journal of Academic Emergency Medicine.
So regarding the study design, this was an objective study which evaluated whether a 50 milliliter bolus of 8.4% sodium bicarbonate produces a serum sodium increase, which is comparable to a 100 ml bolus of 3% hypertonic saline.
And this was a retrospective multicenter cohort study, which was conducted at two hospitals in California between January 2019 and December 2024.
This is primarily a disorder of water balance rather than sodium deficiency.
And it occurs when there is excess body water compared to the total body sodium and potassium.
And so this is most often due to inappropriate vasopressin or antidiuretic hormone activity.
And so the clinical manifestations, that's going to be dependent on the severity of hyponatremia and the rate at which it develops.
We know that in acute hyponatremia, the decrease in serum sodium can result in cerebral edema and severe neurologic complications, whereas chronic hyponatremia often presents with more subtle symptoms, and this is due to cerebral adaption.
Because sodium is the primary determinant of serum osmolality, Rejections in sodium concentrations as well, that promotes water movement into the cells, specifically in the brain.
The rest of this transcript — segmented and speaker-labeled, so you land on the exact moment something was said
Search every transcript — by keyword, by phrase, or by meaning, across every show Radar indexes
Trends — what is surging across podcasts, measured against its own baseline
Alerts — when a name you follow appears in a newly indexed episode
No account is needed to search Radar.
