lithium toxicity

Initial management includes evaluating and stabilizing the airway and circulation.  Saline infusion is the first-line therapy to ensure significant lithium clearance.  Hemodialysis is indicated for serum lithium levels > 4 mEq/L (4 mmol/L) OR levels > 2.5 mEq/L PLUS either signs of significant lithium toxicity (eg, seizures, depressed mental status) or inability to excrete lithium (eg, renal disease, decompensated heart failure).

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