A 93 year old woman comes in with family. They are concerned about general weakness, worsening PO intake over the last few months, and new confusion. As the team takes a history and starts the initial workup, the patient will begin to seize. She will seize continuously until hypertonic saline or a paralytic is given. After two doses of benzodiazepine, a critical result showing severe hyponatremia will come back. The team is expected to administer hypertonic saline, which will stop the seizure. The patient will remain somnolent after this dosing, and as the team prepares to intubate, she will seize again, requiring a repeated dose of hypertonic saline.