MSFinals-4960

A 57-year-old man presents to the emergency department with seizures. He has a history of bipolar disorder and migraines. His medications include lithium, amitriptyline and paracetamol. His partner reports he has recently been using ibuprofen regularly over the counter.

On examination, he is postictal and appears dehydrated. Blood results reveal elevated levels of sodium, potassium, urea, creatinine, and lithium. Resuscitation is initiated with intravenous 0.9% normal saline.

What is the definitive management for this patient’s presentation?