Create a short emergency protocol for an athletic event to prevent and respond to suspected hyponatremia in competitors. Which sequence of actions is most appropriate?

• A. Prevent by educating athletes to drink to thirst and use electrolyte-containing fluids during prolonged events; if neurologic symptoms occur (confusion, seizures), treat as possible hyponatremia — stop oral fluids, call emergency services, and prepare for urgent medical assessment and possible hypertonic saline administration rather than continued plain water
• B. Prevent by instructing athletes to drink only plain water at predetermined intervals regardless of thirst; if symptoms occur, give the athlete more water quickly to restore blood volume and then delay medical care until hydration is observed for several hours
• C. Prevent by mandating sports drinks at every aid station but never offer plain water; if a competitor is symptomatic, induce vomiting to reduce circulating fluid volume quickly and then encourage bed rest
• D. Prevention is unnecessary because hyponatremia is almost always caused by contaminated water sources; if symptoms occur, immediately give large amounts of fruit juice to restore electrolytes and avoid medical services unless symptoms persist for days

Answer: (A)