Three Cases of Severe Hyponatremia During a River Run in Grand Canyon National Park

Three cases of severe hyponatremia, distinct from exercise-associated forms, occurred during a river rafting trip on the Colorado River in Grand Canyon National Park. The patients, all women, exhibited symptoms such as fatigue, emesis, disorientation, or seizure within 24 hours of each other and required intensive care. Unlike typical cases linked to prolonged endurance activities, these instances were not associated with significant physical exertion, highlighting unique diagnostic and treatment challenges in austere settings. The findings underscore the need for preventive measures to avoid overhydration driven by concerns about dehydration.

Pearce, E. A., Myers, T. M., & Hoffman, M. D. (2015). Three Cases of Severe Hyponatremia During a River Run in Grand Canyon National Park. Wilderness & Environmental Medicine, 26(2), 189–195. https://doi.org/10.1016/j.wem.2014.08.007