Sodium Correction Rate
Monitors sodium correction rate in hyponatremia to prevent osmotic demyelination syndrome
- Highest activation tier
- Mandatory
- How it is scored
- Scored in code; a stated value is compared only from the structured summary or a supplied value
- Care settings
- Emergency department, ICU, Inpatient
When it activates
Scribeable activates a calculator from the encounter. The Sodium Correction Rate can activate when the transcript or pasted chart context documents any of these:
- Hyponatremia correction monitoring
- Sodium replacement therapy
- Osmotic demyelination risk assessment
- Hypertonic saline administration
- DDAVP clamp for sodium overcorrection
A coded diagnosis can also activate it. ICD-10 prefixes carried by the registry: E87.1.
Inputs the note needs
3 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; an input marked "asks you" is requested as a clarification when it is undocumented.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Initial serum sodium (mEq/L) | lab | mEq/L | |
| Current serum sodium (mEq/L) | lab | mEq/L | |
| Hours elapsed between measurements | lab | h |
Scoring
Rate = (Current Na - Initial Na) / Hours × 24. Target: ≤8 mEq/L in first 24h for chronic hyponatremia. ≤10-12 mEq/L in 24h for acute (<48h).
Rate = (Current serum sodium (mEq/L) − Initial serum sodium (mEq/L)) / Hours elapsed between measurements × 24
Interpretation
Target ≤8 mEq/L/24h for chronic hyponatremia (risk of osmotic demyelination if exceeded). ≤10-12 mEq/L/24h for acute hyponatremia. If overcorrecting: administer DDAVP 1-2 mcg IV + D5W to relower sodium. High-risk patients (alcoholism, malnutrition, liver disease, hypokalemia): more conservative.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Sterns RH 2015.
- Sterns RH. Disorders of plasma sodium — causes, consequences, and correction (Sodium Correction Rate)Sterns (Sodium Correction) 2015 · 2015 · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the Sodium Correction Rate at the mandatory tier, Scribeable resolves its inputs from the transcript, the pasted chart context and any charted labs, and asks you for a missing input you can supply before the note is finalised. Bedside-exam and separately ordered study values are not requested one input at a time; a calculator that carries a combined clarification question may still put that single question to you.
The score is computed in code from the resolved inputs, not recalled by the language model. A stated Sodium Correction Rate value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.
Classified as a deterministic formula: a spare suggestion is easy to ignore, so activation is permissive.
See it activate on your own encounter
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