First 30 seconds
- 1Assess volume status
- 2Plasma + urine osmolality + urine Na⁺
- 3If severe symptoms: hypertonic saline 150 mL 3% NaCl IV over 10 min
Na⁺ <135 mmol/L. Severe <125 or symptomatic.
A
Airway
- • Patent? Talking? Stridor?
- • Suction, jaw-thrust, adjuncts, definitive airway if needed
B
Breathing
- • RR, SpO₂, auscultate, percuss
- • O₂ to target sats, NIV / intubate as required
C
Circulation
- • HR, BP, cap refill, JVP
- • 2× large-bore IV, bloods, monitor, ECG
D
Disability
- • AVPU/GCS, pupils, glucose, temp
E
Exposure
- • Full exposure, skin, rash, bleeding, lines, infection source
