- An algorithm for the emergency management of acute stroke
- tPA administration guidelines, including complete tPA inclusion and exclusion criteria and guidelines for management of patients receiving tPA
- Indications and guidelines for intra-arterial thrombolysis and mechanical clot extraction
- Quick reference tables for localization of TIAs and strokes, including descriptions of anterior and posterior circulation syndromes
- Illustrations of cerebral and brain stem vasculature and vascular territories
- The NIH Stroke Scale and information on the clinical prognosis of stroke
- Descriptions and indications for use of imaging modalities in stroke management
- Recommendations for stroke workup, hospital management and supportive care
- Secondary stroke prevention recommendations, including guidelines for carotid endarterectomy and antithrombotic therapy in atrial fibrillation
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A-a Gradient EquationA - a gradient = PAO2 - PaO2 Where:
PAO2 = alveolar PO2 (calculated from the alveolar gas equation)
PaO2 = arterial PO2 (measured in arterial blood)
The Alveolar Gas EquationPAO2 = PIO2 - PACO2/R
Where: PIO2 = FIO2 x (760 mmHg - 47mmHg) = inspired O2
- FIO2 = 21% at sea level atmospheric pressure = 0.21
- 760 mmHg = atmospheric pressure at sea level
- 47 mmHg = H2O pressure
PACO2 = arterial PCO2 measured in plasma
R = respiratory exchange ratio or respiratory quotient = 0.8 under normal conditions
Values and MeaningThe normal A-a gradient is < 10 mmHg, but can range from 5-20 mmHg in a normal individual. An increased A-a gradient suggests a diffusion defect, V/Q (ventilation/perfusion) defect, or right-to-left shunt.
Sodium is the major positively charged ion (cation) in the fluid outside of cells of the body. The chemical notation for sodium is Na. When combined with chloride (Cl), the resulting substance is table salt (NaCl).
The normal blood sodium level is 135 - 145 milliEquivalents/liter (mEq/L), or in international units, 135 - 145 millimoles/liter (mmol/L). Results may vary slightly among different laboratories.
[Na] - ([Cl] + [HCO3]) = [other anions] - [other cations] = "Anion Gap"
A serum osmolality test measures the amount of chemicals dissolved in the liquid part (serum) of the blood. Serum osmolality can be calculated by measuring the amounts of sodium, glucose, and blood urea nitrogen (BUN) in the blood.