home *** CD-ROM | disk | FTP | other *** search
| MacBinary | 1994-12-12 | 624.1 KB | [pkg /pkgX] |
open in: 
MacOS 8.1
|
Win98
|
DOS
browse contents |
view JSON data
|
view as text
This file was processed as: MacBinary
(archive/macBinary).
| Confidence | Program | Detection | Match Type | Support
|
|---|
| 66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
| 10%
| dexvert
| MacBinary (archive/macBinary)
| fallback
| Supported |
| 1%
| dexvert
| Newton Package (archive/newtonPackage)
| magic
| Unsupported |
| 1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
| 100%
| file
| MacBinary II, inited, Mon Dec 12 01:39:23 1994, modified Mon Dec 12 01:39:23 1994, creator 'pkgX', type 'pkg ', 638484 bytes "ccsCCMed.gold.pkg"
| default (weak)
| |
| 99%
| file
| Newton package, NOS 1.x, CopyProtect, version 1, at 0x9be94 286 bytes resource
| default
| |
| 98%
| file
| data
| default
| |
| 100%
| TrID
| MacBinary 2
| default (weak)
| |
| 100%
| siegfried
| fmt/1762 MacBinary (II)
| default
| |
| 100%
| lsar
| MacBinary
| default
|
|
| id metadata |
|---|
| key | value |
|---|
| macFileType | [pkg ] |
| macFileCreator | [pkgX] |
hex view+--------+-------------------------+-------------------------+--------+--------+
|00000000| 00 11 63 63 73 43 43 4d | 65 64 2e 67 6f 6c 64 2e |..ccsCCM|ed.gold.|
|00000010| 70 6b 67 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |pkg.....|........|
|00000020| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000030| 00 00 00 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000040| 00 70 6b 67 20 70 6b 67 | 58 01 00 00 00 00 00 00 |.pkg pkg|X.......|
|00000050| 00 00 00 00 09 be 14 00 | 00 01 1e ab 11 a0 9b ab |........|........|
|00000060| 11 a0 9b 00 00 00 00 00 | 00 00 00 00 00 00 00 00 |........|........|
|00000070| 00 00 00 00 00 00 00 00 | 00 00 81 81 47 10 00 00 |........|....G...|
|00000080| 70 61 63 6b 61 67 65 30 | 78 78 78 78 40 00 00 00 |package0|xxxx@...|
|00000090| 00 00 00 01 00 00 00 36 | 00 36 00 12 00 09 be 14 |.......6|.6......|
|000000a0| ab 11 57 59 ab 11 57 59 | 00 00 00 00 00 00 00 dc |..WY..WY|........|
|000000b0| 00 00 00 01 00 00 00 00 | 00 09 bd 38 00 09 bd 38 |........|...8...8|
|000000c0| 62 6f 6f 6b 00 00 00 00 | 00 00 00 81 00 48 00 04 |book....|.....H..|
|000000d0| 00 00 00 00 ff a9 00 31 | 00 39 00 39 00 34 00 20 |.......1|.9.9.4. |
|000000e0| 00 4b 00 32 00 20 00 43 | 00 6f 00 6e 00 73 00 75 |.K.2. .C|.o.n.s.u|
|000000f0| 00 6c 00 74 00 61 00 6e | 00 74 00 73 00 2c 00 20 |.l.t.a.n|.t.s.,. |
|00000100| 00 49 00 6e 00 63 00 2e | 00 00 00 63 00 63 00 73 |.I.n.c..|...c.c.s|
|00000110| 00 43 00 43 00 4d 00 65 | 00 64 00 00 62 6f 6f 6b |.C.C.M.e|.d..book|
|00000120| 4e 65 77 74 6f 6e aa 20 | 54 6f 6f 6c 4b 69 74 20 |Newton. |ToolKit |
|00000130| 50 61 63 6b 61 67 65 20 | a9 20 31 39 39 32 2d 31 |Package |. 1992-1|
|00000140| 39 39 34 2c 20 41 70 70 | 6c 65 20 43 6f 6d 70 75 |994, App|le Compu|
|00000150| 74 65 72 2c 20 49 6e 63 | 2e 00 ff ff 00 00 10 41 |ter, Inc|.......A|
|00000160| 00 00 00 00 00 00 00 02 | 00 00 00 ed 00 00 10 43 |........|.......C|
|00000170| 00 00 00 00 00 00 00 fd | 00 00 01 2d 00 00 14 41 |........|...-...A|
|00000180| 00 00 00 00 00 00 00 00 | 00 00 00 02 00 00 01 15 |........|........|
|00000190| ad ba db ad 00 00 15 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000001a0| ca cb 2b 13 62 6f 6f 6b | 00 ba ba ba 00 00 50 43 |..+.book|......PC|
|000001b0| 00 00 00 00 00 00 01 7d | 00 00 00 04 00 00 03 bd |.......}|........|
|000001c0| 00 00 03 fd 00 00 04 5d | 00 00 04 7d 00 00 04 9d |.......]|...}....|
|000001d0| 00 00 04 b5 0b 56 f0 80 | 00 00 00 10 00 00 04 d5 |.....V..|........|
|000001e0| 00 05 81 0d 00 09 4d 95 | 00 09 4e 85 00 09 9c 15 |......M.|..N.....|
|000001f0| 00 09 b7 ed 00 09 b9 45 | 00 09 bc 2d 00 00 14 41 |.......E|...-...A|
|00000200| 00 00 00 00 00 00 00 00 | 00 00 01 95 00 00 03 a5 |........|........|
|00000210| ad ba db ad 00 00 50 41 | 00 00 00 00 00 00 00 08 |......PA|........|
|00000220| 00 00 00 02 00 00 01 e5 | 00 00 01 fd 00 00 02 15 |........|........|
|00000230| 00 00 02 2d 00 00 02 4d | 00 00 02 6d 00 00 02 85 |...-...M|...m....|
|00000240| 00 00 02 a5 00 00 02 c5 | 00 00 02 dd 00 00 02 f5 |........|........|
|00000250| 00 00 03 15 00 00 03 2d | 00 00 03 45 00 00 03 65 |.......-|...E...e|
|00000260| 00 00 03 85 00 00 18 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000270| eb 2f 83 76 76 65 72 73 | 69 6f 6e 00 00 00 15 40 |./.vvers|ion....@|
|00000280| 00 00 00 00 00 05 55 52 | 69 02 a4 cc 69 73 62 6e |......UR|i...isbn|
|00000290| 00 00 00 00 00 00 16 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000002a0| 8f a5 88 f2 74 69 74 6c | 65 00 ba ba 00 00 1b 40 |....titl|e......@|
|000002b0| 00 00 00 00 00 05 55 52 | c6 53 ba 02 73 68 6f 72 |......UR|.S..shor|
|000002c0| 74 54 69 74 6c 65 00 00 | 00 00 00 00 00 00 1a 40 |tTitle..|.......@|
|000002d0| 00 00 00 00 00 05 55 52 | c5 0a 68 b1 63 6f 70 79 |......UR|..h.copy|
|000002e0| 72 69 67 68 74 00 00 00 | 00 00 00 00 00 00 17 40 |right...|.......@|
|000002f0| 00 00 00 00 00 05 55 52 | 9f 33 0c 7b 61 75 74 68 |......UR|.3.{auth|
|00000300| 6f 72 00 00 00 00 1a 40 | 00 00 00 00 00 05 55 52 |or.....@|......UR|
|00000310| f8 a8 2d be 70 75 62 6c | 69 73 68 65 72 00 00 00 |..-.publ|isher...|
|00000320| 00 00 00 00 00 00 20 40 | 00 00 00 00 00 05 55 52 |...... @|......UR|
|00000330| 40 f8 bb 98 70 75 62 6c | 69 63 61 74 69 6f 6e 44 |@...publ|icationD|
|00000340| 61 74 65 00 00 00 16 40 | 00 00 00 00 00 05 55 52 |ate....@|......UR|
|00000350| 95 18 8c c5 66 6c 61 67 | 73 00 00 02 00 00 15 40 |....flag|s......@|
|00000360| 00 00 00 00 00 05 55 52 | 49 1c 15 ca 64 61 74 61 |......UR|I...data|
|00000370| 00 ba ba ba 00 00 19 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000380| 6a c9 bf 7e 63 6f 6e 74 | 65 6e 74 73 00 00 00 00 |j..~cont|ents....|
|00000390| 00 00 00 00 00 00 17 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000003a0| 20 e2 21 c4 73 74 79 6c | 65 73 00 ba 00 00 16 40 | .!.styl|es.....@|
|000003b0| 00 00 00 00 00 05 55 52 | 08 83 6f d6 68 69 6e 74 |......UR|..o.hint|
|000003c0| 73 00 00 00 00 00 19 40 | 00 00 00 00 00 05 55 52 |s......@|......UR|
|000003d0| fa bd 06 ff 62 72 6f 77 | 73 65 72 73 00 00 68 01 |....brow|sers..h.|
|000003e0| 01 54 f9 a1 00 00 1a 40 | 00 00 00 00 00 05 55 52 |.T.....@|......UR|
|000003f0| 96 df a7 77 54 65 6d 70 | 6c 61 74 65 73 00 ba ba |...wTemp|lates...|
|00000400| ba ba ba ba 00 00 1a 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000410| 15 30 92 2e 72 65 6e 64 | 65 72 69 6e 67 00 00 00 |.0..rend|ering...|
|00000420| 00 00 00 00 00 00 15 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000430| 8e 5c 37 a1 69 63 6f 6e | 00 ba ba ba 00 00 24 40 |.\7.icon|......$@|
|00000440| 00 00 00 00 00 00 03 e5 | 00 63 00 63 00 73 00 63 |........|.c.c.s.c|
|00000450| 00 63 00 4d 00 65 00 64 | 00 3a 00 4b 00 32 00 00 |.c.M.e.d|.:.K.2..|
|00000460| ad ba db ad 00 00 17 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000470| 18 10 f3 5f 53 74 72 69 | 6e 67 00 ba 00 00 5a 40 |..._Stri|ng....Z@|
|00000480| 00 00 00 00 00 00 03 e5 | 00 43 00 75 00 72 00 72 |........|.C.u.r.r|
|00000490| 00 65 00 6e 00 74 00 20 | 00 43 00 6c 00 69 00 6e |.e.n.t. |.C.l.i.n|
|000004a0| 00 69 00 63 00 61 00 6c | 00 20 00 53 00 74 00 72 |.i.c.a.l|. .S.t.r|
|000004b0| 00 61 00 74 00 65 00 67 | 00 69 00 65 00 73 00 3a |.a.t.e.g|.i.e.s.:|
|000004c0| 00 20 00 43 00 72 00 69 | 00 74 00 20 00 43 00 61 |. .C.r.i|.t. .C.a|
|000004d0| 00 72 00 65 00 00 db ad | ad ba db ad 00 00 1e 40 |.r.e....|.......@|
|000004e0| 00 00 00 00 00 00 03 e5 | 00 43 00 72 00 69 00 74 |........|.C.r.i.t|
|000004f0| 00 43 00 61 00 72 00 65 | 00 00 db ad 00 00 1c 40 |.C.a.r.e|.......@|
|00000500| 00 00 00 00 00 00 03 e5 | 00 35 00 2f 00 32 00 36 |........|.5./.2.6|
|00000510| 00 2f 00 39 00 34 00 00 | ad ba db ad 00 00 16 40 |./.9.4..|.......@|
|00000520| 00 00 00 00 00 00 03 e5 | 00 45 00 52 00 4c 00 49 |........|.E.R.L.I|
|00000530| 00 00 db ad 00 00 1c 40 | 00 00 00 00 00 00 03 e5 |.......@|........|
|00000540| 00 45 00 52 00 4c 00 49 | 00 2f 00 4b 00 32 00 00 |.E.R.L.I|./.K.2..|
|00000550| ad ba db ad 00 00 24 43 | 00 00 00 00 00 00 04 fd |......$C|........|
|00000560| 00 00 05 b5 00 00 00 04 | 00 00 01 90 00 08 bb 15 |........|........|
|00000570| 00 04 a7 95 00 00 11 75 | 02 28 c6 f1 00 00 28 41 |.......u|.(....(A|
|00000580| 00 00 00 00 00 00 00 00 | 00 00 00 02 00 00 05 25 |........|.......%|
|00000590| 00 00 05 45 00 00 01 e5 | 00 00 05 65 00 00 05 7d |...E....|...e...}|
|000005a0| 00 00 05 95 00 00 19 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000005b0| 79 0d f1 b6 66 75 6e 63 | 74 69 6f 6e 00 00 00 00 |y...func|tion....|
|000005c0| 00 00 00 00 00 00 1b 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000005d0| 6f 71 3b 61 6b 32 43 6f | 6d 70 72 65 73 73 00 00 |oq;ak2Co|mpress..|
|000005e0| 00 00 00 00 00 00 15 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000005f0| 4c 7a 40 5c 6c 69 73 74 | 00 00 00 00 00 00 16 40 |Lz@\list|.......@|
|00000600| 00 00 00 00 00 05 55 52 | 6f be f9 f0 70 61 67 65 |......UR|o...page|
|00000610| 73 00 00 00 00 00 20 40 | 00 00 00 00 00 05 55 52 |s..... @|......UR|
|00000620| 55 f9 42 f4 63 6f 6d 70 | 72 65 73 73 53 63 72 69 |U.B.comp|ressScri|
|00000630| 70 74 73 00 00 00 2c 43 | 00 00 00 00 00 00 05 e5 |pts...,C|........|
|00000640| 00 00 03 8b 00 00 01 63 | 00 00 07 05 00 00 00 d8 |.......c|........|
|00000650| 00 00 08 04 00 00 07 a5 | 00 00 05 40 00 00 00 02 |........|...@....|
|00000660| ad ba db ad 00 00 30 41 | 00 00 00 00 00 00 00 18 |......0A|........|
|00000670| 00 00 00 02 00 00 06 15 | 00 00 06 2d 00 00 06 4d |........|...-...M|
|00000680| 00 00 06 6d 00 00 06 8d | 00 00 06 ad 00 00 06 cd |...m....|........|
|00000690| 00 00 06 ed 00 00 17 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000006a0| 66 22 43 9b 5f 70 72 6f | 74 6f 00 ba 00 00 19 40 |f"C._pro|to.....@|
|000006b0| 00 00 00 00 00 05 55 52 | e3 a7 a6 62 76 69 65 77 |......UR|...bview|
|000006c0| 46 6f 6e 74 00 ba ba ba | ba ba ba ba 00 00 1b 40 |Font....|.......@|
|000006d0| 00 00 00 00 00 05 55 52 | 5b ba 05 56 76 69 65 77 |......UR|[..Vview|
|000006e0| 42 6f 75 6e 64 73 00 ba | ba ba ba ba 00 00 1c 40 |Bounds..|.......@|
|000006f0| 00 00 00 00 00 05 55 52 | 8b 2e 17 e1 76 69 65 77 |......UR|....view|
|00000700| 4a 75 73 74 69 66 79 00 | ba ba ba ba 00 00 1a 40 |Justify.|.......@|
|00000710| 00 00 00 00 00 05 55 52 | 43 5b 53 68 76 69 65 77 |......UR|C[Shview|
|00000720| 46 6c 61 67 73 00 ba ba | ba ba ba ba 00 00 20 40 |Flags...|...... @|
|00000730| 00 00 00 00 00 05 55 52 | cb 78 ff 46 76 69 65 77 |......UR|.x.Fview|
|00000740| 43 6c 69 63 6b 53 63 72 | 69 70 74 00 00 00 1b 40 |ClickScr|ipt....@|
|00000750| 00 00 00 00 00 05 55 52 | 1f 4b 11 e4 76 69 65 77 |......UR|.K..view|
|00000760| 46 6f 72 6d 61 74 00 ba | ba ba ba ba 00 00 15 40 |Format..|.......@|
|00000770| 00 00 00 00 00 05 55 52 | dc 6d 87 dd 74 65 78 74 |......UR|.m..text|
|00000780| 00 ba ba ba 00 00 1c 43 | 00 00 00 00 00 00 07 25 |.......C|.......%|
|00000790| 00 00 00 80 00 00 01 00 | 00 00 00 08 ff ff ff f8 |........|........|
|000007a0| ad ba db ad 00 00 20 41 | 00 00 00 00 00 00 00 08 |...... A|........|
|000007b0| 00 00 00 02 00 00 07 45 | 00 00 07 5d 00 00 07 75 |.......E|...]...u|
|000007c0| 00 00 07 8d 00 00 14 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000007d0| 2e a8 8a 9b 74 6f 70 00 | ba ba ba ba 00 00 17 40 |....top.|.......@|
|000007e0| 00 00 00 00 00 05 55 52 | db a1 ff ed 62 6f 74 74 |......UR|....bott|
|000007f0| 6f 6d 00 ba 00 00 15 40 | 00 00 00 00 00 05 55 52 |om.....@|......UR|
|00000800| ca cb 2b 13 6c 65 66 74 | 00 ba ba ba 00 00 16 40 |..+.left|.......@|
|00000810| 00 00 00 00 00 05 55 52 | 16 c7 a2 0e 72 69 67 68 |......UR|....righ|
|00000820| 74 00 ba ba 00 00 20 43 | 00 00 00 00 00 00 07 c5 |t..... C|........|
|00000830| 00 00 08 7d 00 00 08 9d | 00 00 08 ad 00 00 09 0d |...}....|........|
|00000840| 00 00 00 04 00 00 24 41 | 00 00 00 00 00 00 00 08 |......$A|........|
|00000850| 00 00 00 02 00 00 07 ed | 00 00 08 05 00 00 08 25 |........|.......%|
|00000860| 00 00 08 45 00 00 08 65 | be ac eb ad 00 00 16 40 |...E...e|.......@|
|00000870| 00 00 00 00 00 05 55 52 | 25 0b d4 46 63 6c 61 73 |......UR|%..Fclas|
|00000880| 73 00 ba ba 00 00 1d 40 | 00 00 00 00 00 05 55 52 |s......@|......UR|
|00000890| 83 a6 3a cd 69 6e 73 74 | 72 75 63 74 69 6f 6e 73 |..:.inst|ructions|
|000008a0| 00 ba ba ba 00 00 19 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000008b0| c3 c1 17 60 6c 69 74 65 | 72 61 6c 73 00 ba ba ba |...`lite|rals....|
|000008c0| ba ba ba ba 00 00 19 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000008d0| 13 e7 40 dd 61 72 67 46 | 72 61 6d 65 00 ba ba ba |..@.argF|rame....|
|000008e0| ba ba ba ba 00 00 18 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|000008f0| 5b 3c 3b f5 6e 75 6d 41 | 72 67 73 00 00 00 1a 40 |[<;.numA|rgs....@|
|00000900| 00 00 00 00 00 05 55 52 | 3f fd 28 d6 43 6f 64 65 |......UR|?.(.Code|
|00000910| 42 6c 6f 63 6b 00 ba ba | ba ba ba ba 00 00 10 40 |Block...|.......@|
|00000920| 00 00 00 00 00 00 08 05 | 18 19 29 02 00 00 14 41 |........|..)....A|
|00000930| 00 00 00 00 00 00 08 25 | 00 00 08 c5 00 00 08 f5 |.......%|........|
|00000940| 00 00 00 02 00 00 2c 40 | 00 00 00 00 00 00 03 e5 |......,@|........|
|00000950| 00 66 00 75 00 6e 00 63 | 00 74 00 69 00 6f 00 6e |.f.u.n.c|.t.i.o.n|
|00000960| 00 20 00 74 00 61 00 70 | 00 70 00 65 00 64 00 00 |. .t.a.p|.p.e.d..|
|00000970| ad ba db ad 00 00 16 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000980| 5c 07 c3 e5 50 72 69 6e | 74 00 ba ba 00 00 1c 43 |\...Prin|t......C|
|00000990| 00 00 00 00 00 00 09 2d | 00 00 09 bd 00 00 0c ad |.......-|........|
|000009a0| 00 00 0c ad 00 00 00 02 | ad ba db ad 00 00 20 41 |........|...... A|
|000009b0| 00 00 00 00 00 00 00 08 | 00 00 00 02 00 00 09 4d |........|.......M|
|000009c0| 00 00 09 6d 00 00 09 85 | 00 00 09 a5 00 00 1e 40 |...m....|.......@|
|000009d0| 00 00 00 00 00 05 55 52 | f1 9e 1a 0b 5f 6e 65 78 |......UR|...._nex|
|000009e0| 74 41 72 67 46 72 61 6d | 65 00 ba ba 00 00 18 40 |tArgFram|e......@|
|000009f0| 00 00 00 00 00 05 55 52 | c5 d5 f0 a1 5f 50 61 72 |......UR|...._Par|
|00000a00| 65 6e 74 00 00 00 1d 40 | 00 00 00 00 00 05 55 52 |ent....@|......UR|
|00000a10| 55 7b 79 93 5f 69 6d 70 | 6c 65 6d 65 6e 74 6f 72 |U{y._imp|lementor|
|00000a20| 00 ba ba ba 00 00 15 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000a30| c5 58 27 40 75 6e 69 74 | 00 00 00 00 00 00 60 43 |.X'@unit|......`C|
|00000a40| 00 00 00 00 00 00 0a 1d | 00 00 0c ad 00 00 0c ad |........|........|
|00000a50| 00 00 0c ad 00 00 21 b0 | 00 00 0c cd 00 00 5e 4d |......!.|......^M|
|00000a60| 00 04 a3 75 00 04 a3 8d | 00 00 00 54 00 04 a7 45 |...u....|...T...E|
|00000a70| 00 04 a7 6d 00 05 77 cd | 00 05 80 e5 00 00 07 58 |...m..w.|.......X|
|00000a80| 00 07 a1 5d 00 00 00 04 | 00 07 a4 6d 00 07 a4 95 |...]....|...m....|
|00000a90| 00 08 ba e5 00 08 bb 05 | 00 00 00 02 00 00 1c 41 |........|.......A|
|00000aa0| 00 00 00 00 00 00 00 00 | 00 00 0a 3d 00 00 0c 65 |........|...=...e|
|00000ab0| 00 00 0c 7d 00 00 0c 95 | ad ba db ad 00 00 58 41 |...}....|......XA|
|00000ac0| 00 00 00 00 00 00 00 08 | 00 00 00 02 00 00 09 4d |........|.......M|
|00000ad0| 00 00 09 6d 00 00 09 85 | 00 00 0a 95 00 00 0a ad |...m....|........|
|00000ae0| 00 00 0a c5 00 00 0a e5 | 00 00 0b 05 00 00 0b 25 |........|.......%|
|00000af0| 00 00 0b 3d 00 00 0b 5d | 00 00 0b 85 00 00 0b 9d |...=...]|........|
|00000b00| 00 00 0b bd 00 00 0b dd | 00 00 0b f5 00 00 0c 15 |........|........|
|00000b10| 00 00 0c 3d 00 00 15 40 | 00 00 00 00 00 05 55 52 |...=...@|......UR|
|00000b20| 01 c7 1a b2 73 6c 6f 74 | 00 ba ba ba 00 00 14 40 |....slot|.......@|
|00000b30| 00 00 00 00 00 05 55 52 | 4b 30 ef 0b 76 61 6c 00 |......UR|K0..val.|
|00000b40| 00 6d 00 73 00 00 1d 40 | 00 00 00 00 00 05 55 52 |.m.s...@|......UR|
|00000b50| 4a 95 71 ed 73 6c 6f 74 | 76 61 6c 7c 69 74 65 72 |J.q.slot|val|iter|
|00000b60| 00 00 00 00 00 00 1a 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000b70| 43 5b 53 68 61 6c 70 68 | 61 53 6c 6f 74 00 00 00 |C[Shalph|aSlot...|
|00000b80| 00 00 00 00 00 00 19 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000b90| 8c c5 27 c1 61 6c 70 68 | 61 56 61 6c 00 00 00 00 |..'.alph|aVal....|
|00000ba0| 00 00 00 00 00 00 14 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000bb0| 87 9f e2 7d 69 64 78 00 | 00 00 00 00 00 00 1c 40 |...}idx.|.......@|
|00000bc0| 00 00 00 00 00 05 55 52 | d0 6e 39 b8 69 64 78 76 |......UR|.n9.idxv|
|00000bd0| 61 6c 7c 69 74 65 72 00 | 00 00 00 00 00 00 27 40 |al|iter.|......'@|
|00000be0| 00 00 00 00 00 05 55 52 | cd bd e3 59 61 6c 70 68 |......UR|...Yalph|
|00000bf0| 61 53 6c 6f 74 61 6c 70 | 68 61 56 61 6c 7c 69 74 |aSlotalp|haVal|it|
|00000c00| 65 72 00 00 00 00 18 40 | 00 00 00 00 00 05 55 52 |er.....@|......UR|
|00000c10| 1e cd 48 83 63 6f 6e 74 | 65 6e 74 00 00 00 1d 40 |..H.cont|ent....@|
|00000c20| 00 00 00 00 00 05 55 52 | 1c 6a b0 b3 63 6f 6e 74 |......UR|.j..cont|
|00000c30| 65 6e 74 7c 69 74 65 72 | 00 00 00 00 00 00 19 40 |ent|iter|.......@|
|00000c40| 00 00 00 00 00 05 55 52 | 25 89 9d a7 70 61 67 65 |......UR|%...page|
|00000c50| 73 6c 6f 74 00 00 00 00 | 00 00 00 00 00 00 15 40 |slot....|.......@|
|00000c60| 00 00 00 00 00 05 55 52 | 23 c2 82 f5 70 61 67 65 |......UR|#...page|
|00000c70| 00 00 00 00 00 00 1c 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000c80| 20 94 63 35 63 6f 6e 74 | 65 6e 74 73 6c 6f 74 00 | .c5cont|entslot.|
|00000c90| 00 00 00 00 00 00 28 40 | 00 00 00 00 00 05 55 52 |......(@|......UR|
|00000ca0| 3c ff 13 e8 63 6f 6e 74 | 65 6e 74 73 6c 6f 74 63 |<...cont|entslotc|
|00000cb0| 6f 6e 74 65 6e 74 7c 69 | 74 65 72 00 00 00 22 40 |ontent|i|ter..."@|
|00000cc0| 00 00 00 00 00 05 55 52 | 46 e9 88 cc 70 61 67 65 |......UR|F...page|
|00000cd0| 73 6c 6f 74 70 61 67 65 | 7c 69 74 65 72 00 00 00 |slotpage||iter...|
|00000ce0| 00 00 00 00 00 00 14 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00000cf0| e3 f5 64 f1 73 74 72 00 | 00 00 00 00 00 00 16 40 |..d.str.|.......@|
|00000d00| 00 00 00 00 00 05 55 52 | 44 f2 63 48 66 69 72 73 |......UR|D.cHfirs|
|00000d10| 74 00 ba ba 00 00 16 40 | 00 00 00 00 00 05 55 52 |t......@|......UR|
|00000d20| 3c 21 34 e3 77 68 65 72 | 65 00 ba ba 00 00 0c 43 |<!4.wher|e......C|
|00000d30| 00 00 00 00 00 00 0c bd | ad ba db ad 00 00 10 41 |........|.......A|
|00000d40| 00 00 00 00 00 00 00 00 | 00 00 00 02 00 00 34 41 |........|......4A|
|00000d50| 00 00 00 00 00 00 0d 05 | 00 00 0d 1d 00 00 0d dd |........|........|
|00000d60| 00 00 0e 25 00 00 22 25 | 00 00 2a 65 00 00 31 bd |...%.."%|..*e..1.|
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|000016f0| 00 69 00 72 00 6f 00 6e | 00 6d 00 65 00 6e 00 74 |.i.r.o.n|.m.e.n.t|
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|00001740| 00 00 00 00 00 00 1c 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
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|000017b0| 00 00 00 00 00 05 55 52 | 99 72 4a 19 68 69 73 74 |......UR|.rJ.hist|
|000017c0| 6f 72 79 54 61 67 73 00 | 00 00 00 00 00 00 20 43 |oryTags.|...... C|
|000017d0| 00 00 00 00 00 00 07 c5 | 00 00 08 7d 00 00 17 6d |........|...}...m|
|000017e0| 00 00 17 85 00 00 17 bd | 00 00 00 08 00 00 14 40 |........|.......@|
|000017f0| 00 00 00 00 00 00 08 05 | 7c 18 91 03 19 38 c4 02 |........||....8..|
|00001800| 00 00 00 00 00 00 14 41 | 00 00 00 00 00 00 08 25 |.......A|.......%|
|00001810| 00 00 17 9d 00 00 13 75 | 00 00 00 02 00 00 19 40 |.......u|.......@|
|00001820| 00 00 00 00 00 05 55 52 | f7 5e dc 6d 74 68 69 73 |......UR|.^.mthis|
|00001830| 50 61 67 65 00 00 00 00 | 00 00 00 00 00 00 20 43 |Page....|...... C|
|00001840| 00 00 00 00 00 00 17 dd | 00 00 00 02 00 00 00 02 |........|........|
|00001850| 00 00 00 02 00 00 00 02 | 00 00 00 02 00 00 24 41 |........|......$A|
|00001860| 00 00 00 00 00 00 00 08 | 00 00 00 02 00 00 09 4d |........|.......M|
|00001870| 00 00 09 6d 00 00 09 85 | 00 00 18 05 00 00 18 1d |...m....|........|
|00001880| ad ba db ad 00 00 12 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00001890| 63 11 d7 98 78 00 ba ba | ba ba ba ba 00 00 12 40 |c...x...|.......@|
|000018a0| 00 00 00 00 00 05 55 52 | 01 49 51 51 79 00 00 00 |......UR|.IQQy...|
|000018b0| 00 05 55 52 00 00 19 40 | 00 00 00 00 00 05 55 52 |..UR...@|......UR|
|000018c0| 45 70 2c a9 41 72 72 61 | 79 50 6f 73 00 ba ba ba |Ep,.Arra|yPos....|
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|00001900| 00 00 00 02 00 00 0d 75 | 00 00 18 95 00 00 17 9d |.......u|........|
|00001910| ad ba db ad 00 00 16 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00001920| 61 7a c7 b8 69 6e 64 65 | 78 00 ba ba 00 00 1b 40 |az..inde|x......@|
|00001930| 00 00 00 00 00 05 55 52 | 89 e4 c6 90 52 65 6d 6f |......UR|....Remo|
|00001940| 76 65 53 6c 6f 74 00 ba | ba ba ba ba 00 00 1c 43 |veSlot..|.......C|
|00001950| 00 00 00 00 00 00 18 ed | 00 00 0c ad 00 00 0c ad |........|........|
|00001960| 00 00 0c ad 00 00 00 02 | ad ba db ad 00 00 20 41 |........|...... A|
|00001970| 00 00 00 00 00 00 00 08 | 00 00 00 02 00 00 09 4d |........|.......M|
|00001980| 00 00 09 6d 00 00 09 85 | 00 00 14 b5 00 00 1f 40 |...m....|.......@|
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|000019a0| 51 75 69 74 53 63 72 69 | 70 74 00 99 00 00 20 43 |QuitScri|pt.... C|
|000019b0| 00 00 00 00 00 00 07 c5 | 00 00 08 7d 00 00 19 4d |........|...}...M|
|000019c0| 00 00 19 6d 00 00 19 9d | 00 00 00 00 00 00 1c 40 |...m....|.......@|
|000019d0| 00 00 00 00 00 00 08 05 | 03 18 91 22 c6 6f 00 0e |........|...".o..|
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|000019f0| 00 00 00 00 00 00 08 25 | 00 00 16 a5 00 00 19 85 |.......%|........|
|00001a00| 00 00 00 02 00 00 16 40 | 00 00 00 00 00 05 55 52 |.......@|......UR|
|00001a10| 25 0b d4 46 43 6c 6f 73 | 65 00 91 21 00 00 18 43 |%..FClos|e..!...C|
|00001a20| 00 00 00 00 00 00 19 b5 | 00 00 0c ad 00 00 0c ad |........|........|
|00001a30| 00 00 0c ad 00 00 1c 41 | 00 00 00 00 00 00 00 08 |.......A|........|
|00001a40| 00 00 00 02 00 00 09 4d | 00 00 09 6d 00 00 09 85 |.......M|...m....|
|00001a50| ad ba db ad 00 08 2c 40 | 00 00 00 00 00 00 03 e5 |......,@|........|
|00001a60| 44 69 61 67 6e 6f 73 74 | 69 63 20 43 6f 6e 73 69 |Diagnost|ic Consi|
|00001a70| 64 65 72 61 74 69 6f 6e | 73 20 0d 43 42 43 2c 20 |deration|s .CBC, |
|00001a80| 53 4d 41 20 31 32 2c 20 | 6f 73 6d 6f 6c 61 6c 69 |SMA 12, |osmolali|
|00001a90| 74 79 2e 20 42 6c 6f 6f | 64 20 43 26 53 20 78 20 |ty. Bloo|d C&S x |
|00001aa0| 32 2e 20 55 41 20 77 69 | 74 68 20 6d 69 63 72 6f |2. UA wi|th micro|
|00001ab0| 2c 20 75 72 69 6e 65 20 | 43 26 53 2e 20 53 74 6f |, urine |C&S. Sto|
|00001ac0| 6f 6c 2c 20 74 68 72 6f | 61 74 2c 20 6e 61 73 61 |ol, thro|at, nasa|
|00001ad0| 6c 20 43 26 53 2e 20 41 | 6e 74 69 62 69 6f 74 69 |l C&S. A|ntibioti|
|00001ae0| 63 20 6c 65 76 65 6c 73 | 20 70 65 61 6b 20 26 20 |c levels| peak & |
|00001af0| 74 72 6f 75 67 68 20 61 | 66 74 65 72 20 33 72 64 |trough a|fter 3rd|
|00001b00| 20 64 6f 73 65 2e 0d 43 | 53 46 20 54 75 62 65 20 | dose..C|SF Tube |
|00001b10| 31 2d 20 43 65 6c 6c 20 | 63 6f 75 6e 74 20 26 20 |1- Cell |count & |
|00001b20| 64 69 66 66 65 72 65 6e | 74 69 61 6c 20 28 31 2d |differen|tial (1-|
|00001b30| 32 20 6d 6c 29 2e 0d 43 | 53 46 20 54 75 62 65 20 |2 ml)..C|SF Tube |
|00001b40| 32 2d 20 47 6c 75 63 6f | 73 65 2c 20 70 72 6f 74 |2- Gluco|se, prot|
|00001b50| 65 69 6e 20 28 31 2d 32 | 20 6d 6c 29 2e 0d 43 53 |ein (1-2| ml)..CS|
|00001b60| 46 20 54 75 62 65 20 33 | 2d 20 47 72 61 6d 20 73 |F Tube 3|- Gram s|
|00001b70| 74 61 69 6e 20 6f 66 20 | 66 6c 75 69 64 20 6f 72 |tain of |fluid or|
|00001b80| 20 73 65 64 69 6d 65 6e | 74 20 28 69 66 20 66 6c | sedimen|t (if fl|
|00001b90| 75 69 64 20 69 73 20 63 | 6c 65 61 72 29 2c 20 43 |uid is c|lear), C|
|00001ba0| 26 53 20 66 6f 72 20 62 | 61 63 74 65 72 69 61 20 |&S for b|acteria |
|00001bb0| 28 31 2d 34 20 6d 6c 29 | 2e 0d 43 53 46 20 54 75 |(1-4 ml)|..CSF Tu|
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|00002960| 66 61 69 6c 75 72 65 2f | 64 79 73 70 68 61 67 69 |failure/|dysphagi|
|00002970| 61 3b 20 65 78 63 68 61 | 6e 67 65 20 32 35 30 20 |a; excha|nge 250 |
|00002980| 63 63 2f 6b 67 20 6f 76 | 65 72 20 37 20 74 6f 20 |cc/kg ov|er 7 to |
|00002990| 31 34 20 64 61 79 73 3b | 20 6d 61 79 20 6e 65 65 |14 days;| may nee|
|000029a0| 64 20 74 6f 20 72 65 70 | 65 61 74 20 77 69 74 68 |d to rep|eat with|
|000029b0| 20 72 65 63 75 72 72 65 | 6e 63 65 2e 20 50 6c 61 | recurre|nce. Pla|
|000029c0| 73 6d 61 70 68 65 72 65 | 73 69 73 20 68 61 73 20 |smaphere|sis has |
|000029d0| 6d 69 6e 69 6d 61 6c 20 | 69 6d 70 61 63 74 20 6f |minimal |impact o|
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|000029f0| 69 63 79 6c 61 74 65 2c | 20 70 72 65 64 6e 69 73 |icylate,| prednis|
|00002a00| 6f 6c 6f 6e 65 2c 20 74 | 6f 62 72 61 6d 79 63 69 |olone, t|obramyci|
|00002a10| 6e 2c 20 64 69 67 6f 78 | 69 6e 2c 20 64 69 67 69 |n, digox|in, digi|
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|00002a40| 74 61 6c 2e 20 4d 6f 73 | 74 20 64 72 75 67 73 2c |tal. Mos|t drugs,|
|00002a50| 20 77 69 74 68 20 74 68 | 65 20 65 78 63 65 70 74 | with th|e except|
|00002a60| 69 6f 6e 20 6f 66 20 70 | 6f 74 61 73 73 69 75 6d |ion of p|otassium|
|00002a70| 20 61 6e 64 20 70 72 6f | 63 61 69 6e 61 6d 69 64 | and pro|cainamid|
|00002a80| 65 2c 20 64 6f 20 6e 6f | 74 20 72 65 71 75 69 72 |e, do no|t requir|
|00002a90| 65 20 73 75 70 70 6c 65 | 6d 65 6e 74 61 74 69 6f |e supple|mentatio|
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|00002ab0| 65 72 65 73 69 73 20 6f | 72 20 70 6c 61 73 6d 61 |eresis o|r plasma|
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|00002ad0| 00 00 00 00 00 00 0d 05 | 00 00 00 00 00 00 09 c8 |........|........|
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|00002af0| 00 00 2a bd 00 00 2b 0d | 00 00 11 75 00 00 2a bd |..*...+.|...u..*.|
|00002b00| 00 00 06 44 00 00 2b 7d | 00 00 31 a5 00 00 2c 41 |...D..+}|..1...,A|
|00002b10| 00 00 00 00 00 00 00 00 | 00 00 00 02 00 00 02 dd |........|........|
|00002b20| 00 00 03 15 00 00 0e 7d | 00 00 05 25 00 00 0e 95 |.......}|...%....|
|00002b30| 00 00 0e b5 00 00 0e cd | ad ba db ad 00 00 4c 40 |........|......L@|
|00002b40| 00 00 00 00 00 00 03 e5 | 00 49 00 4e 00 43 00 52 |........|.I.N.C.R|
|00002b50| 00 45 00 41 00 53 00 45 | 00 44 00 20 00 49 00 4e |.E.A.S.E|.D. .I.N|
|00002b60| 00 54 00 52 00 41 00 43 | 00 52 00 41 00 4e 00 49 |.T.R.A.C|.R.A.N.I|
|00002b70| 00 41 00 4c 00 20 00 50 | 00 52 00 45 00 53 00 53 |.A.L. .P|.R.E.S.S|
|00002b80| 00 55 00 52 00 45 00 00 | ad ba db ad 00 00 6c 41 |.U.R.E..|......lA|
|00002b90| 00 00 00 00 00 00 0d 05 | 00 00 00 38 00 00 10 a5 |........|...8....|
|00002ba0| 00 00 01 d0 00 00 11 3d | 00 00 00 2c 00 00 10 a5 |.......=|...,....|
|00002bb0| 00 00 01 b4 00 00 11 3d | 00 00 00 84 00 00 10 a5 |.......=|........|
|00002bc0| 00 00 02 84 00 00 11 3d | 00 00 00 48 00 00 10 a5 |.......=|...H....|
|00002bd0| 00 00 02 90 00 00 11 3d | 00 00 00 28 00 00 10 a5 |.......=|...(....|
|00002be0| 00 00 01 dc 00 00 11 3d | 00 00 00 68 00 00 10 a5 |.......=|...h....|
|00002bf0| 00 00 0c 20 00 00 11 3d | ad ba db ad 00 06 21 40 |... ...=|......!@|
|00002c00| 00 00 00 00 00 00 03 e5 | 50 72 65 73 65 6e 74 61 |........|Presenta|
|00002c10| 74 69 6f 6e 20 0d 68 65 | 61 64 61 63 68 65 2c 20 |tion .he|adache, |
|00002c20| 6c 65 74 68 61 72 67 79 | 3b 20 62 6c 75 72 72 69 |lethargy|; blurri|
|00002c30| 6e 67 20 6f 66 20 76 69 | 73 69 6f 6e 20 6c 65 61 |ng of vi|sion lea|
|00002c40| 64 69 6e 67 20 74 6f 20 | 67 72 61 64 75 61 6c 20 |ding to |gradual |
|00002c50| 62 6c 69 6e 64 6e 65 73 | 73 20 69 6e 20 63 68 72 |blindnes|s in chr|
|00002c60| 6f 6e 69 63 20 63 61 73 | 65 73 2c 20 6c 65 74 68 |onic cas|es, leth|
|00002c70| 61 72 67 79 2c 20 64 69 | 70 6c 6f 70 69 61 2c 20 |argy, di|plopia, |
|00002c80| 76 6f 6d 69 74 69 6e 67 | 2e 0d 44 69 61 67 6e 6f |vomiting|..Diagno|
|00002c90| 73 69 73 20 0d 43 54 2f | 4d 52 49 20 6f 66 20 68 |sis .CT/|MRI of h|
|00002ca0| 65 61 64 3b 20 69 6e 74 | 72 61 63 72 61 6e 69 61 |ead; int|racrania|
|00002cb0| 6c 20 70 72 65 73 73 75 | 72 65 20 6d 6f 6e 69 74 |l pressu|re monit|
|00002cc0| 6f 72 3b 20 6c 75 6d 62 | 61 72 20 70 75 6e 63 74 |or; lumb|ar punct|
|00002cd0| 75 72 65 20 69 73 20 63 | 6f 6e 74 72 61 69 6e 64 |ure is c|ontraind|
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|00002cf0| 67 69 63 61 6c 20 65 76 | 61 6c 75 61 74 69 6f 6e |gical ev|aluation|
|00002d00| 2e 0d 49 6e 74 65 72 76 | 65 6e 74 69 6f 6e 73 20 |..Interv|entions |
|00002d10| 0d 48 79 70 65 72 76 65 | 6e 74 69 6c 61 74 69 6f |.Hyperve|ntilatio|
|00002d20| 6e 20 0d 73 68 6f 72 74 | 20 6c 6f 6e 67 20 74 65 |n .short| long te|
|00002d30| 72 6d 20 62 65 6e 65 66 | 69 74 20 6d 61 79 20 62 |rm benef|it may b|
|00002d40| 65 20 6c 69 66 65 20 73 | 61 76 69 6e 67 20 69 6e |e life s|aving in|
|00002d50| 20 63 61 73 65 73 20 6f | 66 20 68 65 72 6e 69 61 | cases o|f hernia|
|00002d60| 74 69 6f 6e 3b 20 61 64 | 6d 69 6e 69 73 74 65 72 |tion; ad|minister|
|00002d70| 20 6e 6f 6e 74 6f 78 69 | 63 20 6c 65 76 65 6c 73 | nontoxi|c levels|
|00002d80| 20 6f 66 20 6f 78 79 67 | 65 6e 3b 20 6d 61 69 6e | of oxyg|en; main|
|00002d90| 74 61 69 6e 20 6d 69 6c | 64 20 72 65 73 70 69 72 |tain mil|d respir|
|00002da0| 61 74 6f 72 79 20 61 6c | 6b 61 6c 6f 73 69 73 20 |atory al|kalosis |
|00002db0| 2d 20 50 61 43 4f 32 20 | 32 35 2d 33 30 20 6d 6d |- PaCO2 |25-30 mm|
|00002dc0| 48 67 2e 0d 4f 73 6d 6f | 74 69 63 20 44 69 75 72 |Hg..Osmo|tic Diur|
|00002dd0| 65 73 69 73 20 0d 4d 61 | 6e 6e 69 74 6f 6c 20 31 |esis .Ma|nnitol 1|
|00002de0| 20 67 6d 2f 6b 67 20 66 | 6f 6c 6c 6f 77 65 64 20 | gm/kg f|ollowed |
|00002df0| 62 79 20 30 2e 32 35 20 | 67 6d 2f 6b 67 20 49 56 |by 0.25 |gm/kg IV|
|00002e00| 20 71 69 64 3b 20 61 76 | 6f 69 64 20 68 79 70 65 | qid; av|oid hype|
|00002e10| 72 6f 73 6d 6f 6c 61 72 | 69 74 79 20 2d 20 6b 65 |rosmolar|ity - ke|
|00002e20| 65 70 20 73 65 72 75 6d | 20 6f 73 6d 6f 6c 61 72 |ep serum| osmolar|
|00002e30| 69 74 79 20 6c 65 73 73 | 20 74 68 61 6e 20 33 31 |ity less| than 31|
|00002e40| 35 20 6d 4f 73 6d 2f 4c | 3b 20 69 6e 69 74 69 61 |5 mOsm/L|; initia|
|00002e50| 6c 20 65 66 66 65 63 74 | 73 20 6f 63 63 75 72 73 |l effect|s occurs|
|00002e60| 20 69 6e 20 6c 65 73 73 | 20 74 68 61 6e 20 36 30 | in less| than 60|
|00002e70| 20 6d 69 6e 75 74 65 73 | 2e 0d 53 74 65 72 6f 69 | minutes|..Steroi|
|00002e80| 64 73 20 0d 44 65 78 61 | 6d 65 74 68 61 73 6f 6e |ds .Dexa|methason|
|00002e90| 65 20 28 61 6e 74 69 2d | 65 64 65 6d 61 20 65 66 |e (anti-|edema ef|
|00002ea0| 66 65 63 74 29 3b 20 31 | 30 20 6d 67 20 69 6e 69 |fect); 1|0 mg ini|
|00002eb0| 74 69 61 6c 6c 79 20 66 | 6f 6c 6c 6f 77 65 64 20 |tially f|ollowed |
|00002ec0| 62 79 20 34 20 6d 67 20 | 71 36 68 20 49 56 2f 50 |by 4 mg |q6h IV/P|
|00002ed0| 4f 3b 20 63 68 65 63 6b | 20 67 6c 75 63 6f 73 65 |O; check| glucose|
|00002ee0| 3b 20 61 76 6f 69 64 20 | 6c 6f 6e 67 20 74 65 72 |; avoid |long ter|
|00002ef0| 6d 20 74 68 65 72 61 70 | 79 2e 0d 54 72 65 61 74 |m therap|y..Treat|
|00002f00| 6d 65 6e 74 20 43 6f 6e | 73 69 64 65 72 61 74 69 |ment Con|siderati|
|00002f10| 6f 6e 73 20 0d 2d 43 6f | 6e 73 69 64 65 72 20 72 |ons .-Co|nsider r|
|00002f20| 65 73 74 72 69 63 74 69 | 6e 67 20 66 6c 75 69 64 |estricti|ng fluid|
|00002f30| 73 20 74 6f 20 20 31 2f | 32 20 6d 61 69 6e 74 65 |s to 1/|2 mainte|
|00002f40| 6e 61 6e 63 65 2c 20 69 | 73 6f 74 6f 6e 69 63 20 |nance, i|sotonic |
|00002f50| 66 6c 75 69 64 73 2e 20 | 48 65 61 64 20 6f 66 20 |fluids. |Head of |
|00002f60| 62 65 64 20 61 74 20 33 | 30 20 64 65 67 72 65 65 |bed at 3|0 degree|
|00002f70| 73 2c 20 68 65 61 64 20 | 6d 69 64 6c 69 6e 65 2e |s, head |midline.|
|00002f80| 0d 2d 4d 61 6e 6e 69 74 | 6f 6c 2c 20 31 30 30 20 |.-Mannit|ol, 100 |
|00002f90| 67 6d 20 28 31 2d 32 20 | 67 6d 2f 6b 67 29 20 49 |gm (1-2 |gm/kg) I|
|00002fa0| 56 20 6f 76 65 72 20 31 | 30 2d 32 30 20 6d 69 6e |V over 1|0-20 min|
|00002fb0| 20 28 32 35 25 20 73 6f | 6c 75 74 69 6f 6e 29 2c | (25% so|lution),|
|00002fc0| 20 72 65 70 65 61 74 65 | 64 20 71 34 2d 36 68 20 | repeate|d q4-6h |
|00002fd0| 61 73 20 6e 65 65 64 65 | 64 3b 20 69 6e 20 6c 65 |as neede|d; in le|
|00002fe0| 73 73 20 73 65 76 65 72 | 65 20 73 69 74 75 61 74 |ss sever|e situat|
|00002ff0| 69 6f 6e 73 20 67 69 76 | 65 20 35 30 20 67 6d 20 |ions giv|e 50 gm |
|00003000| 49 56 20 28 30 2e 35 2d | 31 20 67 6d 2f 6b 67 29 |IV (0.5-|1 gm/kg)|
|00003010| 28 6b 65 65 70 20 6f 73 | 6d 6f 6c 61 72 69 74 79 |(keep os|molarity|
|00003020| 20 3c 33 31 35 3b 20 64 | 6f 20 6e 6f 74 20 67 69 | <315; d|o not gi|
|00003030| 76 65 20 66 6f 72 20 3e | 34 38 68 3b 0d 2d 4e 65 |ve for >|48h;.-Ne|
|00003040| 75 72 6f 6d 75 73 63 75 | 6c 61 72 20 62 6c 6f 63 |uromuscu|lar bloc|
|00003050| 6b 61 64 65 20 74 6f 20 | 64 65 63 72 65 61 73 65 |kade to |decrease|
|00003060| 20 69 6e 74 72 61 74 68 | 6f 72 61 63 69 63 20 70 | intrath|oracic p|
|00003070| 72 65 73 73 75 72 65 20 | 72 65 73 75 6c 74 69 6e |ressure |resultin|
|00003080| 67 20 69 6e 20 64 65 63 | 72 65 61 73 65 20 63 65 |g in dec|rease ce|
|00003090| 72 65 62 72 61 6c 20 62 | 6c 6f 6f 64 20 66 6c 6f |rebral b|lood flo|
|000030a0| 77 2e 20 43 6f 6e 63 75 | 72 72 65 6e 74 20 75 73 |w. Concu|rrent us|
|000030b0| 65 20 6f 66 20 61 6d 6e | 65 73 69 63 20 61 6e 64 |e of amn|esic and|
|000030c0| 2f 6f 72 20 73 65 64 61 | 74 69 76 65 20 61 67 65 |/or seda|tive age|
|000030d0| 6e 74 73 20 69 73 20 6d | 61 6e 64 61 74 6f 72 79 |nts is m|andatory|
|000030e0| 2e 0d 2d 47 6c 79 63 65 | 72 6f 6c 20 31 20 67 6d |..-Glyce|rol 1 gm|
|000030f0| 2f 6b 67 20 49 56 20 71 | 36 68 2e 0d 2d 50 65 6e |/kg IV q|6h..-Pen|
|00003100| 74 6f 62 61 72 62 69 74 | 61 6c 20 28 62 61 72 62 |tobarbit|al (barb|
|00003110| 69 74 75 72 61 74 65 20 | 63 6f 6d 61 29 20 37 2e |iturate |coma) 7.|
|00003120| 35 20 6d 67 2f 6b 67 2f | 68 20 49 56 20 66 6f 72 |5 mg/kg/|h IV for|
|00003130| 20 33 68 2c 20 74 68 65 | 6e 20 32 2d 33 20 6d 67 | 3h, the|n 2-3 mg|
|00003140| 2f 6b 67 2f 68 20 49 56 | 20 69 6e 66 75 73 69 6f |/kg/h IV| infusio|
|00003150| 6e 2c 20 6d 61 69 6e 74 | 61 69 6e 20 49 43 50 20 |n, maint|ain ICP |
|00003160| 3c 20 31 35 20 6d 6d 48 | 67 2c 20 43 50 50 20 3e |< 15 mmH|g, CPP >|
|00003170| 20 35 30 20 6d 6d 48 67 | 2c 20 4d 41 50 20 3e 20 | 50 mmHg|, MAP > |
|00003180| 37 30 20 6d 6d 48 67 2c | 20 61 6e 64 20 70 65 6e |70 mmHg,| and pen|
|00003190| 74 6f 62 61 72 62 69 74 | 61 6c 20 6c 65 76 65 6c |tobarbit|al level|
|000031a0| 20 6f 66 20 32 35 2d 34 | 30 20 6d 67 2f 4c 2e 20 | of 25-4|0 mg/L. |
|000031b0| 55 73 65 20 62 61 72 62 | 69 74 75 72 61 74 65 20 |Use barb|iturate |
|000031c0| 63 6f 6d 61 20 69 66 20 | 68 79 70 65 72 76 65 6e |coma if |hyperven|
|000031d0| 74 69 6c 61 74 69 6f 6e | 2c 20 6f 73 6d 6f 74 69 |tilation|, osmoti|
|000031e0| 63 20 64 69 75 72 65 73 | 69 73 20 61 6e 64 20 6e |c diures|is and n|
|000031f0| 65 75 72 6f 6d 75 73 63 | 75 6c 61 72 20 62 6c 6f |euromusc|ular blo|
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|00003210| 20 69 6e 61 64 65 71 75 | 61 74 65 2e 00 ba db ad | inadequ|ate.....|
|00003220| ad ba db ad 00 00 18 41 | 00 00 00 00 00 00 0d 05 |.......A|........|
|00003230| 00 00 00 00 00 00 08 84 | 00 00 12 d4 00 00 28 43 |........|......(C|
|00003240| 00 00 00 00 00 00 31 e5 | 00 00 32 15 00 00 32 55 |......1.|..2...2U|
|00003250| 00 00 11 75 00 00 32 15 | 00 00 06 20 00 00 33 05 |...u..2.|... ..3.|
|00003260| 00 00 38 cd 00 00 2c 41 | 00 00 00 00 00 00 00 00 |..8...,A|........|
|00003270| 00 00 00 02 00 00 02 dd | 00 00 03 15 00 00 0e 7d |........|.......}|
|00003280| 00 00 05 25 00 00 0e 95 | 00 00 0e b5 00 00 0e cd |...%....|........|
|00003290| ad ba db ad 00 00 3c 40 | 00 00 00 00 00 00 03 e5 |......<@|........|
|000032a0| 00 49 00 4e 00 54 00 52 | 00 41 00 43 00 52 00 41 |.I.N.T.R|.A.C.R.A|
|000032b0| 00 4e 00 49 00 41 00 4c | 00 20 00 48 00 45 00 4d |.N.I.A.L|. .H.E.M|
|000032c0| 00 4f 00 52 00 52 00 48 | 00 41 00 47 00 45 00 00 |.O.R.R.H|.A.G.E..|
|000032d0| ad ba db ad 00 00 ac 41 | 00 00 00 00 00 00 0d 05 |.......A|........|
|000032e0| 00 00 00 40 00 00 10 a5 | 00 00 00 04 00 00 11 3d |...@....|.......=|
|000032f0| 00 00 00 38 00 00 10 a5 | 00 00 01 f8 00 00 11 3d |...8....|.......=|
|00003300| 00 00 00 2c 00 00 10 a5 | 00 00 04 58 00 00 11 3d |...,....|...X...=|
|00003310| 00 00 00 60 00 00 10 a5 | 00 00 02 40 00 00 11 3d |...`....|...@...=|
|00003320| 00 00 00 68 00 00 10 a5 | 00 00 02 f8 00 00 11 3d |...h....|.......=|
|00003330| 00 00 00 a0 00 00 10 a5 | 00 00 00 bc 00 00 11 3d |........|.......=|
|00003340| 00 00 00 50 00 00 10 a5 | 00 00 01 e8 00 00 11 3d |...P....|.......=|
|00003350| 00 00 00 6c 00 00 10 a5 | 00 00 03 78 00 00 11 3d |...l....|...x...=|
|00003360| 00 00 00 94 00 00 10 a5 | 00 00 00 08 00 00 11 3d |........|.......=|
|00003370| 00 00 00 30 00 00 10 a5 | 00 00 01 b0 00 00 11 3d |...0....|.......=|
|00003380| ad ba db ad 00 05 c7 40 | 00 00 00 00 00 00 03 e5 |.......@|........|
|00003390| 49 6e 74 72 61 70 61 72 | 65 6e 63 68 79 6d 61 6c |Intrapar|enchymal|
|000033a0| 0d 50 72 65 73 65 6e 74 | 61 74 69 6f 6e 20 0d 53 |.Present|ation .S|
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|00003480| 61 6d 75 73 2f 70 6f 6e | 73 2f 63 65 72 65 62 65 |amus/pon|s/cerebe|
|00003490| 6c 6c 75 6d 29 3b 20 6c | 75 6d 62 61 72 20 70 75 |llum); l|umbar pu|
|000034a0| 6e 63 74 75 72 65 20 6d | 61 79 20 62 65 20 63 6f |ncture m|ay be co|
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|000034e0| 73 74 75 64 69 65 73 20 | 69 6e 63 6c 75 64 69 6e |studies |includin|
|000034f0| 67 20 50 54 2f 50 54 54 | 2c 20 43 42 43 3b 20 63 |g PT/PTT|, CBC; c|
|00003500| 6f 6e 73 69 64 65 72 20 | 61 6e 67 69 6f 67 72 61 |onsider |angiogra|
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|00003540| 6c 66 6f 72 6d 61 74 69 | 6f 6e 73 29 2e 0d 44 69 |lformati|ons)..Di|
|00003550| 66 66 65 72 65 6e 74 69 | 61 6c 20 44 69 61 67 6e |fferenti|al Diagn|
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|00003570| 70 69 64 75 72 61 6c 20 | 68 65 6d 61 74 6f 6d 61 |pidural |hematoma|
|00003580| 2c 20 73 65 69 7a 75 72 | 65 2c 20 6e 65 6f 70 6c |, seizur|e, neopl|
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|000035a0| 67 6c 69 6f 62 6c 61 73 | 74 6f 6d 61 29 2c 20 74 |glioblas|toma), t|
|000035b0| 6f 78 69 6e 73 20 28 63 | 6f 63 61 69 6e 65 2c 20 |oxins (c|ocaine, |
|000035c0| 61 6d 70 68 65 74 61 6d | 69 6e 65 29 2c 20 64 69 |amphetam|ine), di|
|000035d0| 73 73 65 6d 69 6e 61 74 | 65 64 20 69 6e 74 72 61 |sseminat|ed intra|
|000035e0| 76 61 73 63 75 6c 61 72 | 20 63 6f 61 67 75 6c 61 |vascular| coagula|
|000035f0| 74 69 6f 6e 2e 0d 54 72 | 65 61 74 6d 65 6e 74 20 |tion..Tr|eatment |
|00003600| 43 6f 6e 73 69 64 65 72 | 61 74 69 6f 6e 73 20 0d |Consider|ations .|
|00003610| 47 65 6e 65 72 61 6c 20 | 6d 65 61 73 75 72 65 73 |General |measures|
|00003620| 20 28 44 56 54 20 70 72 | 6f 70 68 79 6c 61 78 69 | (DVT pr|ophylaxi|
|00003630| 73 20 77 69 74 68 20 70 | 6e 65 75 6d 61 74 69 63 |s with p|neumatic|
|00003640| 20 63 6f 6d 70 72 65 73 | 73 69 6f 6e 20 73 74 6f | compres|sion sto|
|00003650| 63 6b 69 6e 67 73 2c 20 | 62 65 64 20 72 65 73 74 |ckings, |bed rest|
|00003660| 2c 20 61 63 65 74 61 6d | 69 6e 6f 70 68 65 6e 2c |, acetam|inophen,|
|00003670| 20 73 74 6f 6f 6c 20 73 | 6f 66 74 65 6e 65 72 73 | stool s|ofteners|
|00003680| 2c 20 4e 65 75 72 6f 6c | 6f 67 79 2f 4e 65 75 72 |, Neurol|ogy/Neur|
|00003690| 6f 73 75 72 67 65 72 79 | 20 63 6f 6e 73 75 6c 74 |osurgery| consult|
|000036a0| 61 74 69 6f 6e 2c 20 70 | 68 79 73 69 63 61 6c 2f |ation, p|hysical/|
|000036b0| 6f 63 63 75 70 61 74 69 | 6f 6e 61 6c 2f 73 70 65 |occupati|onal/spe|
|000036c0| 65 63 68 20 74 68 65 72 | 61 70 79 29 2e 0d 49 6e |ech ther|apy)..In|
|000036d0| 74 65 72 76 65 6e 74 69 | 6f 6e 73 20 0d 49 6e 64 |terventi|ons .Ind|
|000036e0| 69 63 61 74 69 6f 6e 73 | 20 66 6f 72 20 53 75 72 |ications| for Sur|
|000036f0| 67 65 72 79 20 0d 63 65 | 72 65 62 65 6c 6c 61 72 |gery .ce|rebellar|
|00003700| 2c 20 61 63 63 65 6c 65 | 72 61 74 69 6e 73 20 6c |, accele|ratins l|
|00003710| 6f 62 61 72 2c 20 68 79 | 64 72 6f 63 65 70 68 61 |obar, hy|drocepha|
|00003720| 6c 75 73 2e 0d 53 65 69 | 7a 75 72 65 20 4d 61 6e |lus..Sei|zure Man|
|00003730| 61 67 65 6d 65 6e 74 20 | 0d 50 68 65 6e 79 74 6f |agement |.Phenyto|
|00003740| 69 6e 20 31 35 20 2d 20 | 32 30 20 6d 67 2f 6b 67 |in 15 - |20 mg/kg|
|00003750| 20 49 56 20 6c 6f 61 64 | 20 4e 53 20 61 74 20 6d | IV load| NS at m|
|00003760| 61 78 69 6d 75 6d 20 72 | 61 74 65 20 6f 66 20 35 |aximum r|ate of 5|
|00003770| 30 20 6d 67 2f 6d 69 6e | 2c 20 74 68 65 6e 20 31 |0 mg/min|, then 1|
|00003780| 30 30 20 6d 67 20 49 56 | 50 20 71 38 68 20 6f 72 |00 mg IV|P q8h or|
|00003790| 20 32 30 30 20 6d 67 20 | 49 56 50 20 71 31 32 68 | 200 mg |IVP q12h|
|000037a0| 2c 20 6d 6f 6e 69 74 6f | 72 20 6c 65 76 65 6c 73 |, monito|r levels|
|000037b0| 2e 2e 0d 49 6e 74 72 61 | 63 72 61 6e 69 61 6c 20 |...Intra|cranial |
|000037c0| 48 79 70 65 72 74 65 6e | 73 69 6f 6e 20 0d 66 72 |Hyperten|sion .fr|
|000037d0| 6f 6d 20 68 65 6d 61 74 | 6f 6d 61 2f 63 65 72 65 |om hemat|oma/cere|
|000037e0| 62 72 61 6c 20 65 64 65 | 6d 61 3b 20 69 61 74 72 |bral ede|ma; iatr|
|000037f0| 6f 67 65 6e 69 63 20 68 | 79 70 65 72 76 65 6e 74 |ogenic h|ypervent|
|00003800| 69 6c 61 74 69 6f 6e 20 | 69 73 20 6d 6f 73 74 20 |ilation |is most |
|00003810| 62 65 6e 65 66 69 63 69 | 61 6c 3b 20 63 6f 6e 73 |benefici|al; cons|
|00003820| 69 64 65 72 20 73 74 65 | 72 6f 69 64 73 3b 20 73 |ider ste|roids; s|
|00003830| 68 75 6e 74 69 6e 67 20 | 66 6f 72 20 68 79 64 72 |hunting |for hydr|
|00003840| 6f 63 65 70 68 61 6c 75 | 73 3b 20 6d 61 6e 6e 69 |ocephalu|s; manni|
|00003850| 74 6f 6c 20 31 20 67 6d | 2f 6b 67 20 66 6f 6c 6c |tol 1 gm|/kg foll|
|00003860| 6f 77 65 64 20 62 79 20 | 30 2e 32 35 20 67 6d 2f |owed by |0.25 gm/|
|00003870| 6b 67 20 70 72 6e 20 2d | 20 6d 6f 6e 69 74 6f 72 |kg prn -| monitor|
|00003880| 20 65 6c 65 63 74 72 6f | 6c 79 74 65 73 2e 20 43 | electro|lytes. C|
|00003890| 6f 6e 73 69 64 65 72 20 | 70 65 6e 74 6f 62 61 72 |onsider |pentobar|
|000038a0| 62 69 74 61 6c 20 63 6f | 6d 61 20 0d 28 73 65 65 |bital co|ma .(see|
|000038b0| 20 49 4e 43 52 45 41 53 | 45 44 20 49 4e 54 52 41 | INCREAS|ED INTRA|
|000038c0| 43 52 41 4e 49 41 4c 20 | 50 52 45 53 53 55 52 45 |CRANIAL |PRESSURE|
|000038d0| 29 2e 0d 42 50 20 43 6f | 6e 74 72 6f 6c 20 0d 61 |)..BP Co|ntrol .a|
|000038e0| 76 6f 69 64 20 68 79 70 | 6f 74 65 6e 73 69 6f 6e |void hyp|otension|
|000038f0| 2c 20 6b 65 65 70 20 4d | 41 50 20 39 30 20 2d 20 |, keep M|AP 90 - |
|00003900| 31 30 30 20 6d 6d 48 67 | 3b 20 4c 61 62 65 74 61 |100 mmHg|; Labeta|
|00003910| 6c 6f 6c 20 32 30 20 2d | 20 38 30 20 6d 67 20 49 |lol 20 -| 80 mg I|
|00003920| 56 50 20 71 31 35 6d 69 | 6e 20 6f 72 20 30 2e 35 |VP q15mi|n or 0.5|
|00003930| 20 2d 20 32 2e 30 20 6d | 67 2f 6d 69 6e 20 49 56 | - 2.0 m|g/min IV|
|00003940| 20 69 6e 66 75 73 69 6f | 6e 2e 00 ad 00 00 18 41 | infusio|n......A|
|00003950| 00 00 00 00 00 00 0d 05 | 00 00 00 00 00 00 09 64 |........|.......d|
|00003960| 00 00 13 18 00 00 28 43 | 00 00 00 00 00 00 39 0d |......(C|......9.|
|00003970| 00 00 39 3d 00 00 39 95 | 00 00 11 75 00 00 39 3d |..9=..9.|...u..9=|
|00003980| 00 00 06 04 00 00 3a 0d | 00 00 3d 85 00 00 2c 41 |......:.|..=...,A|
|00003990| 00 00 00 00 00 00 00 00 | 00 00 00 02 00 00 02 dd |........|........|
|000039a0| 00 00 03 15 00 00 0e 7d | 00 00 05 25 00 00 0e 95 |.......}|...%....|
|000039b0| 00 00 0e b5 00 00 0e cd | ad ba db ad 00 00 58 40 |........|......X@|
|000039c0| 00 00 00 00 00 00 03 e5 | 00 4d 00 41 00 4e 00 41 |........|.M.A.N.A|
|000039d0| 00 47 00 45 00 4d 00 45 | 00 4e 00 54 00 20 00 4f |.G.E.M.E|.N.T. .O|
|000039e0| 00 46 00 20 00 54 00 48 | 00 45 00 20 00 55 00 4e |.F. .T.H|.E. .U.N|
|000039f0| 00 43 00 4f 00 4e 00 53 | 00 43 00 49 00 4f 00 55 |.C.O.N.S|.C.I.O.U|
|00003a00| 00 53 00 20 00 50 00 41 | 00 54 00 49 00 45 00 4e |.S. .P.A|.T.I.E.N|
|00003a10| 00 54 00 00 00 00 74 41 | 00 00 00 00 00 00 0d 05 |.T....tA|........|
|00003a20| 00 00 00 0c 00 00 11 3d | 00 00 00 a4 00 00 10 a5 |.......=|........|
|00003a30| 00 00 00 68 00 00 11 3d | 00 00 00 34 00 00 10 a5 |...h...=|...4....|
|00003a40| 00 00 02 b0 00 00 11 3d | 00 00 00 50 00 00 10 a5 |.......=|...P....|
|00003a50| 00 00 01 68 00 00 11 3d | 00 00 01 88 00 00 10 a5 |...h...=|........|
|00003a60| 00 00 00 0c 00 00 11 3d | 00 00 00 48 00 00 10 a5 |.......=|...H....|
|00003a70| 00 00 01 6c 00 00 11 3d | 00 00 00 3c 00 00 10 a5 |...l...=|...<....|
|00003a80| 00 00 04 60 00 00 11 3d | ad ba db ad 00 03 72 40 |...`...=|......r@|
|00003a90| 00 00 00 00 00 00 03 e5 | 31 2e 20 4d 61 69 6e 74 |........|1. Maint|
|00003aa0| 61 69 6e 20 61 69 72 77 | 61 79 2c 20 62 72 65 61 |ain airw|ay, brea|
|00003ab0| 74 68 69 6e 67 2c 20 63 | 69 72 63 75 6c 61 74 69 |thing, c|irculati|
|00003ac0| 6f 6e 2c 20 61 6e 64 20 | 61 64 6d 69 6e 69 73 74 |on, and |administ|
|00003ad0| 65 72 20 6f 78 79 67 65 | 6e 2e 0d 32 2e 20 4f 62 |er oxyge|n..2. Ob|
|00003ae0| 74 61 69 6e 20 4c 61 62 | 73 20 0d 43 42 43 2c 20 |tain Lab|s .CBC, |
|00003af0| 65 6c 65 63 74 72 6f 6c | 79 74 65 73 2c 20 63 72 |electrol|ytes, cr|
|00003b00| 65 61 74 69 6e 69 6e 65 | 2c 20 42 55 4e 2c 20 6d |eatinine|, BUN, m|
|00003b10| 61 67 6e 65 73 69 75 6d | 2c 20 63 61 6c 63 69 75 |agnesium|, calciu|
|00003b20| 6d 2c 20 67 6c 75 63 6f | 73 65 2c 20 74 6f 78 69 |m, gluco|se, toxi|
|00003b30| 63 6f 6c 6f 67 79 20 73 | 63 72 65 65 6e 2c 20 74 |cology s|creen, t|
|00003b40| 79 70 65 20 61 6e 64 20 | 63 72 6f 73 73 2c 20 6c |ype and |cross, l|
|00003b50| 69 76 65 72 20 66 75 6e | 63 74 69 6f 6e 20 74 65 |iver fun|ction te|
|00003b60| 73 74 2c 20 50 54 2f 50 | 54 54 2e 20 43 6f 6e 73 |st, PT/P|TT. Cons|
|00003b70| 69 64 65 72 20 62 6c 6f | 6f 64 20 63 75 6c 74 75 |ider blo|od cultu|
|00003b80| 72 65 73 2c 20 61 6c 63 | 6f 68 6f 6c 20 6c 65 76 |res, alc|ohol lev|
|00003b90| 65 6c 2e 0d 33 2e 20 41 | 64 6d 69 6e 69 73 74 65 |el..3. A|dministe|
|00003ba0| 72 20 47 6c 75 63 6f 73 | 65 2c 20 32 35 20 67 6d |r Glucos|e, 25 gm|
|00003bb0| 20 28 35 30 20 6d 6c 20 | 6f 66 20 35 30 25 20 64 | (50 ml |of 50% d|
|00003bc0| 65 78 74 72 6f 73 65 20 | 49 56 20 70 75 73 68 29 |extrose |IV push)|
|00003bd0| 2e 20 43 6f 6e 73 69 64 | 65 72 20 6e 61 6c 6f 78 |. Consid|er nalox|
|00003be0| 6f 6e 65 20 28 4e 61 72 | 63 61 6e 29 20 30 2e 34 |one (Nar|can) 0.4|
|00003bf0| 2d 32 2e 30 20 6d 67 20 | 49 56 2f 49 4d 2f 45 54 |-2.0 mg |IV/IM/ET|
|00003c00| 2e 0d 34 2e 20 43 6f 6e | 73 69 64 65 72 20 6d 65 |..4. Con|sider me|
|00003c10| 61 73 75 72 65 73 20 74 | 6f 20 72 65 64 75 63 65 |asures t|o reduce|
|00003c20| 20 65 6c 65 76 61 74 65 | 64 20 69 6e 74 72 61 63 | elevate|d intrac|
|00003c30| 72 61 6e 69 61 6c 20 70 | 72 65 73 73 75 72 65 20 |ranial p|ressure |
|00003c40| 28 73 65 65 20 49 4e 43 | 52 45 41 53 45 44 20 49 |(see INC|REASED I|
|00003c50| 4e 54 52 41 43 52 41 4e | 49 41 4c 20 50 52 45 53 |NTRACRAN|IAL PRES|
|00003c60| 53 55 52 45 29 20 0d 35 | 2e 20 43 6f 6e 74 72 6f |SURE) .5|. Contro|
|00003c70| 6c 20 53 65 69 7a 75 72 | 65 73 20 0d 2d 4c 6f 72 |l Seizur|es .-Lor|
|00003c80| 61 7a 65 70 61 6d 20 28 | 41 74 69 76 61 6e 29 20 |azepam (|Ativan) |
|00003c90| 34 20 2d 20 38 20 6d 67 | 20 6f 72 20 64 69 61 7a |4 - 8 mg| or diaz|
|00003ca0| 65 70 61 6d 20 28 56 61 | 6c 69 75 6d 29 20 35 2d |epam (Va|lium) 5-|
|00003cb0| 31 30 20 6d 67 20 49 56 | 20 70 75 73 68 20 66 6f |10 mg IV| push fo|
|00003cc0| 6c 6c 6f 77 65 64 20 62 | 79 20 64 69 6c 61 6e 74 |llowed b|y dilant|
|00003cd0| 69 6e 2e 0d 36 2e 20 4e | 75 63 68 61 6c 20 52 69 |in..6. N|uchal Ri|
|00003ce0| 67 69 64 69 74 79 3a 20 | 6c 75 6d 62 61 72 20 70 |gidity: |lumbar p|
|00003cf0| 75 6e 63 74 75 72 65 20 | 61 6e 64 20 70 61 6e 63 |uncture |and panc|
|00003d00| 75 6c 74 75 72 65 20 66 | 6f 6c 6c 6f 77 65 64 20 |ulture f|ollowed |
|00003d10| 62 79 20 61 70 70 72 6f | 70 72 69 61 74 65 20 61 |by appro|priate a|
|00003d20| 6e 74 69 62 69 6f 74 69 | 63 20 74 68 65 72 61 70 |ntibioti|c therap|
|00003d30| 79 2e 0d 37 2e 20 45 76 | 61 6c 75 61 74 65 20 70 |y..7. Ev|aluate p|
|00003d40| 48 2c 20 61 6e 64 20 63 | 6f 6e 73 69 64 65 72 20 |H, and c|onsider |
|00003d50| 63 6f 72 72 65 63 74 69 | 6f 6e 20 6f 66 20 61 63 |correcti|on of ac|
|00003d60| 69 64 2f 62 61 73 65 20 | 73 74 61 74 75 73 2e 20 |id/base |status. |
|00003d70| 4e 6f 72 6d 61 6c 69 7a | 65 20 74 65 6d 70 65 72 |Normaliz|e temper|
|00003d80| 61 74 75 72 65 3b 20 63 | 6f 6e 73 69 64 65 72 20 |ature; c|onsider |
|00003d90| 61 64 6d 69 6e 69 73 74 | 72 61 74 69 6f 6e 20 6f |administ|ration o|
|00003da0| 66 20 74 68 69 61 6d 69 | 6e 65 20 31 30 30 20 6d |f thiami|ne 100 m|
|00003db0| 67 20 49 56 20 70 75 73 | 68 2e 20 50 72 6f 74 65 |g IV pus|h. Prote|
|00003dc0| 63 74 20 61 67 61 69 6e | 73 74 20 62 72 69 67 68 |ct again|st brigh|
|00003dd0| 74 20 6c 69 67 68 74 2c | 20 61 6e 64 20 63 6f 6e |t light,| and con|
|00003de0| 73 69 64 65 72 20 73 65 | 64 61 74 69 6f 6e 20 66 |sider se|dation f|
|00003df0| 6f 72 20 61 67 69 74 61 | 74 69 6f 6e 2e 00 db ad |or agita|tion....|
|00003e00| ad ba db ad 00 00 14 41 | 00 00 00 00 00 00 0d 05 |.......A|........|
|00003e10| 00 00 00 00 00 00 08 f0 | ad ba db ad 00 00 28 43 |........|......(C|
|00003e20| 00 00 00 00 00 00 3d c5 | 00 00 3d f5 00 00 3e 3d |......=.|..=...>=|
|00003e30| 00 00 11 75 00 00 3d f5 | 00 00 06 50 00 00 3e 9d |...u..=.|...P..>.|
|00003e40| 00 00 46 35 00 00 2c 41 | 00 00 00 00 00 00 00 00 |..F5..,A|........|
|00003e50| 00 00 00 02 00 00 02 dd | 00 00 03 15 00 00 0e 7d |........|.......}|
|00003e60| 00 00 05 25 00 00 0e 95 | 00 00 0e b5 00 00 0e cd |...%....|........|
|00003e70| ad ba db ad 00 00 46 40 | 00 00 00 00 00 00 03 e5 |......F@|........|
|00003e80| 00 53 00 45 00 49 00 5a | 00 55 00 52 00 45 00 20 |.S.E.I.Z|.U.R.E. |
|00003e90| 00 26 00 20 00 53 00 54 | 00 41 00 54 00 55 00 53 |.&. .S.T|.A.T.U.S|
|00003ea0| 00 20 00 45 00 50 00 49 | 00 4c 00 45 00 50 00 54 |. .E.P.I|.L.E.P.T|
|00003eb0| 00 49 00 43 00 55 00 53 | 00 00 db ad 00 00 5c 41 |.I.C.U.S|......\A|
|00003ec0| 00 00 00 00 00 00 0d 05 | 00 00 00 2c 00 00 10 a5 |........|...,....|
|00003ed0| 00 00 06 78 00 00 11 3d | 00 00 00 60 00 00 10 a5 |...x...=|...`....|
|00003ee0| 00 00 04 98 00 00 11 3d | 00 00 00 88 00 00 10 a5 |.......=|........|
|00003ef0| 00 00 0c e0 00 00 11 3d | 00 00 00 6c 00 00 10 a5 |.......=|...l....|
|00003f00| 00 00 04 28 00 00 11 3d | 00 00 00 74 00 00 10 a5 |...(...=|...t....|
|00003f10| 00 00 00 08 00 00 11 3d | ad ba db ad 00 07 91 40 |.......=|.......@|
|00003f20| 00 00 00 00 00 00 03 e5 | 44 69 61 67 6e 6f 73 69 |........|Diagnosi|
|00003f30| 73 20 0d 4f 62 74 61 69 | 6e 20 64 65 73 63 72 69 |s .Obtai|n descri|
|00003f40| 70 74 69 6f 6e 20 6f 66 | 20 73 65 69 7a 75 72 65 |ption of| seizure|
|00003f50| 20 66 72 6f 6d 20 77 69 | 74 6e 65 73 73 3b 20 64 | from wi|tness; d|
|00003f60| 72 75 67 20 6c 65 76 65 | 6c 73 2c 20 74 6f 78 69 |rug leve|ls, toxi|
|00003f70| 63 6f 6c 6f 67 79 20 73 | 63 72 65 65 6e 2c 20 43 |cology s|creen, C|
|00003f80| 42 43 20 77 69 74 68 20 | 64 69 66 66 65 72 65 6e |BC with |differen|
|00003f90| 74 69 61 6c 2c 20 65 6c | 65 63 74 72 6f 6c 79 74 |tial, el|ectrolyt|
|00003fa0| 65 73 20 28 68 69 67 68 | 20 61 6e 69 6f 6e 20 67 |es (high| anion g|
|00003fb0| 61 70 29 2c 20 67 6c 75 | 63 6f 73 65 2c 20 42 55 |ap), glu|cose, BU|
|00003fc0| 4e 2f 63 72 65 61 74 69 | 6e 69 6e 65 2c 20 63 61 |N/creati|nine, ca|
|00003fd0| 6c 63 69 75 6d 2c 20 6d | 61 67 6e 65 73 69 75 6d |lcium, m|agnesium|
|00003fe0| 3b 20 45 45 47 20 28 6d | 61 79 20 62 65 20 6e 6f |; EEG (m|ay be no|
|00003ff0| 72 6d 61 6c 20 69 6e 20 | 69 6e 74 65 72 69 63 74 |rmal in |interict|
|00004000| 61 6c 20 70 65 72 69 6f | 64 20 6f 72 20 63 6f 6e |al perio|d or con|
|00004010| 74 69 6e 75 6f 75 73 20 | 73 70 69 6b 69 6e 67 20 |tinuous |spiking |
|00004020| 77 69 74 68 20 67 65 6e | 65 72 61 6c 69 7a 65 64 |with gen|eralized|
|00004030| 2c 20 66 6f 63 61 6c 20 | 73 70 69 6b 69 6e 67 20 |, focal |spiking |
|00004040| 77 69 74 68 20 70 61 72 | 74 69 61 6c 20 6d 6f 74 |with par|tial mot|
|00004050| 6f 72 2c 20 32 20 48 7a | 20 73 70 69 6b 65 73 20 |or, 2 Hz| spikes |
|00004060| 61 6e 64 20 73 6c 6f 77 | 20 77 61 76 65 73 20 77 |and slow| waves w|
|00004070| 69 74 68 20 63 6f 6d 70 | 6c 65 78 20 70 61 72 74 |ith comp|lex part|
|00004080| 69 61 6c 20 73 65 69 7a | 75 72 65 73 29 3b 20 45 |ial seiz|ures); E|
|00004090| 4b 47 3b 20 43 54 20 6f | 66 20 68 65 61 64 20 77 |KG; CT o|f head w|
|000040a0| 68 65 6e 20 73 74 61 62 | 6c 65 20 28 68 65 6d 6f |hen stab|le (hemo|
|000040b0| 72 72 68 61 67 65 2c 20 | 74 75 6d 6f 72 29 3b 20 |rrhage, |tumor); |
|000040c0| 6c 75 6d 62 61 72 20 70 | 75 6e 63 74 75 72 65 2e |lumbar p|uncture.|
|000040d0| 0d 44 69 66 66 65 72 65 | 6e 74 69 61 6c 20 44 69 |.Differe|ntial Di|
|000040e0| 61 67 6e 6f 73 69 73 20 | 0d 54 6f 78 69 6e 73 20 |agnosis |.Toxins |
|000040f0| 28 64 72 75 67 73 2c 20 | 77 69 74 68 64 72 61 77 |(drugs, |withdraw|
|00004100| 61 6c 29 2c 20 6d 65 74 | 61 62 6f 6c 69 63 20 28 |al), met|abolic (|
|00004110| 68 79 70 65 72 2f 68 79 | 70 6f 67 6c 79 63 65 6d |hyper/hy|poglycem|
|00004120| 69 61 2c 20 68 79 70 65 | 72 2f 68 79 70 6f 6e 61 |ia, hype|r/hypona|
|00004130| 74 72 65 6d 69 61 2c 20 | 68 79 70 6f 63 61 6c 63 |tremia, |hypocalc|
|00004140| 65 6d 69 61 3b 20 68 79 | 70 6f 6d 61 67 6e 65 73 |emia; hy|pomagnes|
|00004150| 65 6d 69 61 2c 20 61 6e | 6f 78 69 61 2c 20 65 6e |emia, an|oxia, en|
|00004160| 63 65 70 68 61 6c 6f 70 | 61 74 68 79 20 2d 20 75 |cephalop|athy - u|
|00004170| 72 65 6d 69 63 2f 68 65 | 70 61 74 69 63 29 2c 20 |remic/he|patic), |
|00004180| 62 61 63 74 65 72 69 61 | 6c 20 6f 72 20 76 69 72 |bacteria|l or vir|
|00004190| 61 6c 20 69 6e 66 65 63 | 74 69 6f 6e 20 28 6d 65 |al infec|tion (me|
|000041a0| 6e 69 6e 67 69 74 69 73 | 2f 65 6e 63 65 70 68 61 |ningitis|/encepha|
|000041b0| 6c 69 74 69 73 29 3b 20 | 74 75 6d 6f 72 73 2c 20 |litis); |tumors, |
|000041c0| 63 65 72 65 62 72 6f 76 | 61 73 63 75 6c 61 72 20 |cerebrov|ascular |
|000041d0| 61 63 63 69 64 65 6e 74 | 2c 20 73 68 69 76 65 72 |accident|, shiver|
|000041e0| 69 6e 67 2c 20 73 65 70 | 73 69 73 2c 20 66 61 63 |ing, sep|sis, fac|
|000041f0| 74 69 74 69 6f 75 73 2c | 20 6f 74 68 65 72 20 43 |titious,| other C|
|00004200| 4e 53 20 69 6e 66 65 63 | 74 69 6f 6e 73 2e 0d 4d |NS infec|tions..M|
|00004210| 61 6e 61 67 65 6d 65 6e | 74 20 6f 66 20 53 74 61 |anagemen|t of Sta|
|00004220| 74 75 73 20 45 70 69 6c | 65 70 74 69 63 75 73 20 |tus Epil|epticus |
|00004230| 0d 31 2e 20 4d 61 69 6e | 74 61 69 6e 20 61 69 72 |.1. Main|tain air|
|00004240| 77 61 79 3b 20 69 6e 74 | 75 62 61 74 65 20 61 73 |way; int|ubate as|
|00004250| 20 6e 65 63 65 73 73 61 | 72 79 3b 20 6d 6f 6e 69 | necessa|ry; moni|
|00004260| 74 6f 72 20 63 61 72 64 | 69 6f 70 75 6c 6d 6f 6e |tor card|iopulmon|
|00004270| 61 72 79 20 73 74 61 74 | 75 73 2e 0d 32 2e 20 49 |ary stat|us..2. I|
|00004280| 6e 74 72 61 76 65 6e 6f | 75 73 20 6c 69 6e 65 20 |ntraveno|us line |
|00004290| 77 69 74 68 20 6e 6f 72 | 6d 61 6c 20 73 61 6c 69 |with nor|mal sali|
|000042a0| 6e 65 3b 20 64 72 61 77 | 20 6c 61 62 73 3b 20 61 |ne; draw| labs; a|
|000042b0| 64 6d 69 6e 69 73 74 65 | 72 20 54 68 69 61 6d 69 |dministe|r Thiami|
|000042c0| 6e 65 20 35 30 20 6d 67 | 20 49 56 2c 20 44 35 30 |ne 50 mg| IV, D50|
|000042d0| 20 35 30 20 63 63 2c 20 | 4e 61 6c 6f 78 6f 6e 65 | 50 cc, |Naloxone|
|000042e0| 20 30 2e 34 20 6d 67 20 | 49 56 2e 0d 33 2e 20 41 | 0.4 mg |IV..3. A|
|000042f0| 64 6d 69 6e 69 73 74 65 | 72 20 6c 6f 72 61 7a 65 |dministe|r loraze|
|00004300| 70 61 6d 20 30 2e 31 20 | 6d 67 2f 6b 67 20 49 56 |pam 0.1 |mg/kg IV|
|00004310| 20 62 6f 6c 75 73 2e 0d | 34 2e 20 49 6d 6d 65 64 | bolus..|4. Immed|
|00004320| 69 61 74 65 6c 79 20 66 | 6f 6c 6c 6f 77 20 77 69 |iately f|ollow wi|
|00004330| 74 68 20 70 68 65 6e 79 | 74 6f 69 6e 20 32 30 20 |th pheny|toin 20 |
|00004340| 6d 67 2f 6b 67 20 49 56 | 20 6c 6f 61 64 20 61 74 |mg/kg IV| load at|
|00004350| 20 35 30 20 6d 67 2f 6d | 69 6e 2e 20 4d 61 79 20 | 50 mg/m|in. May |
|00004360| 67 69 76 65 20 70 68 65 | 6e 79 74 6f 69 6e 20 62 |give phe|nytoin b|
|00004370| 6f 6c 75 73 65 73 20 61 | 74 20 35 20 6d 67 2f 6b |oluses a|t 5 mg/k|
|00004380| 67 20 28 6d 61 78 20 33 | 30 20 6d 67 2f 6b 67 29 |g (max 3|0 mg/kg)|
|00004390| 2e 0d 35 2e 20 49 66 20 | 73 65 69 7a 69 6e 67 20 |..5. If |seizing |
|000043a0| 70 65 72 73 69 73 74 73 | 20 61 66 74 65 72 20 70 |persists| after p|
|000043b0| 68 65 6e 79 74 6f 69 6e | 2c 20 70 68 65 6e 6f 62 |henytoin|, phenob|
|000043c0| 61 72 62 69 74 61 6c 20 | 31 35 20 2d 20 32 30 20 |arbital |15 - 20 |
|000043d0| 6d 67 2f 6b 67 20 49 56 | 20 61 74 20 31 30 30 20 |mg/kg IV| at 100 |
|000043e0| 6d 67 2f 6d 69 6e 2e 20 | 49 6e 74 75 62 61 74 65 |mg/min. |Intubate|
|000043f0| 20 66 6f 72 20 61 69 72 | 77 61 79 20 70 72 6f 74 | for air|way prot|
|00004400| 65 63 74 69 6f 6e 2e 0d | 36 2e 20 49 66 20 73 65 |ection..|6. If se|
|00004410| 69 7a 69 6e 67 20 73 74 | 69 6c 6c 20 70 65 72 73 |izing st|ill pers|
|00004420| 69 73 74 73 2c 20 63 6f | 6d 61 20 69 6e 64 75 63 |ists, co|ma induc|
|00004430| 74 69 6f 6e 20 77 69 74 | 68 20 70 65 6e 74 6f 62 |tion wit|h pentob|
|00004440| 61 72 62 69 74 61 6c 20 | 61 74 20 35 20 2d 20 31 |arbital |at 5 - 1|
|00004450| 30 20 6d 67 2f 6b 67 20 | 49 56 20 6c 6f 61 64 2c |0 mg/kg |IV load,|
|00004460| 20 66 6f 6c 6c 6f 77 65 | 64 20 62 79 20 6d 61 69 | followe|d by mai|
|00004470| 6e 74 65 6e 61 6e 63 65 | 20 69 6e 66 75 73 69 6f |ntenance| infusio|
|00004480| 6e 20 6f 66 20 31 2e 30 | 20 6d 67 2f 6b 67 2f 68 |n of 1.0| mg/kg/h|
|00004490| 72 2e 20 43 6f 6e 74 69 | 6e 75 6f 75 73 20 45 45 |r. Conti|nuous EE|
|000044a0| 47 20 2d 20 6d 6f 6e 69 | 74 6f 72 20 66 6f 72 20 |G - moni|tor for |
|000044b0| 62 75 72 73 74 20 73 75 | 70 70 72 65 73 73 69 6f |burst su|ppressio|
|000044c0| 6e 2e 20 53 74 6f 70 20 | 70 65 6e 74 6f 62 61 72 |n. Stop |pentobar|
|000044d0| 62 69 74 61 6c 20 61 74 | 20 31 32 20 68 6f 75 72 |bital at| 12 hour|
|000044e0| 73 20 61 6e 64 20 72 65 | 61 73 73 65 73 73 20 28 |s and re|assess (|
|000044f0| 63 6f 6e 74 72 61 69 6e | 64 69 63 61 74 69 6f 6e |contrain|dication|
|00004500| 73 3a 20 70 72 65 67 6e | 61 6e 63 79 2c 20 70 6f |s: pregn|ancy, po|
|00004510| 72 70 68 79 72 69 61 2c | 20 6c 61 63 6b 20 6f 66 |rphyria,| lack of|
|00004520| 20 65 73 74 61 62 6c 69 | 73 68 65 64 20 61 69 72 | establi|shed air|
|00004530| 77 61 79 29 2e 20 41 6e | 74 69 63 6f 6e 76 75 6c |way). An|ticonvul|
|00004540| 73 61 6e 74 20 70 65 6e | 74 6f 62 61 72 62 69 74 |sant pen|tobarbit|
|00004550| 61 6c 20 6c 65 76 65 6c | 20 69 73 20 35 20 2d 20 |al level| is 5 - |
|00004560| 31 30 20 6d 67 2f 4c 2e | 0d 44 69 61 67 6e 6f 73 |10 mg/L.|.Diagnos|
|00004570| 74 69 63 20 43 6f 6e 73 | 69 64 65 72 61 74 69 6f |tic Cons|ideratio|
|00004580| 6e 73 20 0d 43 42 43 2c | 20 53 4d 41 20 37 2c 20 |ns .CBC,| SMA 7, |
|00004590| 4d 67 2c 20 63 61 6c 63 | 69 75 6d 2c 20 70 68 6f |Mg, calc|ium, pho|
|000045a0| 73 70 68 61 74 65 2c 20 | 70 72 6f 6c 61 63 74 69 |sphate, |prolacti|
|000045b0| 6e 2c 20 43 50 4b 20 69 | 73 6f 65 6e 7a 79 6d 65 |n, CPK i|soenzyme|
|000045c0| 73 2c 20 6c 69 76 65 72 | 20 70 61 6e 65 6c 2c 20 |s, liver| panel, |
|000045d0| 74 68 79 72 6f 69 64 20 | 70 61 6e 65 6c 2c 20 62 |thyroid |panel, b|
|000045e0| 6c 6f 6f 64 20 61 6c 63 | 6f 68 6f 6c 2c 20 56 44 |lood alc|ohol, VD|
|000045f0| 52 4c 2c 20 41 42 47 2c | 20 61 6e 74 69 63 6f 6e |RL, ABG,| anticon|
|00004600| 76 75 6c 73 61 6e 74 20 | 6c 65 76 65 6c 73 2e 20 |vulsant |levels. |
|00004610| 55 41 2c 20 64 72 75 67 | 20 73 63 72 65 65 6e 2e |UA, drug| screen.|
|00004620| 20 4d 52 49 20 77 69 74 | 68 20 26 20 77 69 74 68 | MRI wit|h & with|
|00004630| 6f 75 74 20 67 61 64 6f | 6c 69 6e 69 75 6d 2c 20 |out gado|linium, |
|00004640| 43 54 3b 20 45 45 47 20 | 77 69 74 68 20 68 79 70 |CT; EEG |with hyp|
|00004650| 65 72 76 65 6e 74 69 6c | 61 74 69 6f 6e 2c 20 70 |erventil|ation, p|
|00004660| 68 6f 74 69 63 20 73 74 | 69 6d 75 6c 61 74 69 6f |hotic st|imulatio|
|00004670| 6e 3b 20 43 58 52 2c 20 | 45 43 47 2c 20 6c 75 6d |n; CXR, |ECG, lum|
|00004680| 62 61 72 20 70 75 6e 63 | 74 75 72 65 20 0d 28 73 |bar punc|ture .(s|
|00004690| 65 65 20 53 55 42 41 52 | 41 43 48 4e 4f 49 44 20 |ee SUBAR|ACHNOID |
|000046a0| 48 45 4d 4f 52 52 48 41 | 47 45 29 2e 00 ba db ad |HEMORRHA|GE).....|
|000046b0| ad ba db ad 00 00 18 41 | 00 00 00 00 00 00 0d 05 |.......A|........|
|000046c0| 00 00 00 00 00 00 0b 14 | 00 00 16 6c 00 00 28 43 |........|...l..(C|
|000046d0| 00 00 00 00 00 00 46 75 | 00 00 46 a5 00 00 46 cd |......Fu|..F...F.|
|000046e0| 00 00 11 75 00 00 46 a5 | 00 00 04 7c 00 00 48 6d |...u..F.|...|..Hm|
|000046f0| 00 00 50 85 00 00 2c 41 | 00 00 00 00 00 00 00 00 |..P...,A|........|
|00004700| 00 00 00 02 00 00 02 dd | 00 00 03 15 00 00 0e 7d |........|.......}|
|00004710| 00 00 05 25 00 00 0e 95 | 00 00 0e b5 00 00 0e cd |...%....|........|
|00004720| ad ba db ad 00 00 26 40 | 00 00 00 00 00 00 03 e5 |......&@|........|
|00004730| 00 53 00 45 00 50 00 54 | 00 49 00 43 00 20 00 53 |.S.E.P.T|.I.C. .S|
|00004740| 00 48 00 4f 00 43 00 4b | 00 00 db ad 00 01 9c 41 |.H.O.C.K|.......A|
|00004750| 00 00 00 00 00 00 0d 05 | 00 00 00 6c 00 00 10 a5 |........|...l....|
|00004760| 00 00 04 d4 00 00 11 3d | 00 00 00 28 00 00 10 a5 |.......=|...(....|
|00004770| 00 00 01 5c 00 00 11 3d | 00 00 00 68 00 00 10 a5 |...\...=|...h....|
|00004780| 00 00 01 2c 00 00 11 3d | 00 00 00 ac 00 00 10 a5 |...,...=|........|
|00004790| 00 00 01 e8 00 00 11 3d | 00 00 00 10 00 00 10 a5 |.......=|........|
|000047a0| 00 00 00 70 00 00 11 3d | 00 00 00 10 00 00 10 a5 |...p...=|........|
|000047b0| 00 00 02 ac 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|000047c0| 00 00 00 9c 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|000047d0| 00 00 00 90 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|000047e0| 00 00 00 dc 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|000047f0| 00 00 00 94 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|00004800| 00 00 00 9c 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|00004810| 00 00 00 9c 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|00004820| 00 00 00 68 00 00 11 3d | 00 00 00 08 00 00 10 a5 |...h...=|........|
|00004830| 00 00 00 ec 00 00 11 3d | 00 00 00 0c 00 00 10 a5 |.......=|........|
|00004840| 00 00 01 64 00 00 11 3d | 00 00 00 0c 00 00 10 a5 |...d...=|........|
|00004850| 00 00 00 b8 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|00004860| 00 00 00 ac 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|00004870| 00 00 00 cc 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|00004880| 00 00 01 7c 00 00 11 3d | 00 00 00 08 00 00 10 a5 |...|...=|........|
|00004890| 00 00 01 14 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|000048a0| 00 00 01 cc 00 00 11 3d | 00 00 00 cc 00 00 10 a5 |.......=|........|
|000048b0| 00 00 01 40 00 00 11 3d | 00 00 00 0c 00 00 10 a5 |...@...=|........|
|000048c0| 00 00 00 94 00 00 11 3d | 00 00 00 28 00 00 10 a5 |.......=|...(....|
|000048d0| 00 00 00 b0 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|000048e0| 00 00 00 e4 00 00 11 3d | ad ba db ad 00 08 18 40 |.......=|.......@|
|000048f0| 00 00 00 00 00 00 03 e5 | 44 69 61 67 6e 6f 73 74 |........|Diagnost|
|00004900| 69 63 20 43 6f 6e 73 69 | 64 65 72 61 74 69 6f 6e |ic Consi|deration|
|00004910| 73 20 0d 43 42 43 20 77 | 69 74 68 20 64 69 66 66 |s .CBC w|ith diff|
|00004920| 65 72 65 6e 74 69 61 6c | 2c 20 53 4d 41 20 37 20 |erential|, SMA 7 |
|00004930| 26 20 31 32 2c 20 62 6c | 6f 6f 64 20 43 26 53 20 |& 12, bl|ood C&S |
|00004940| 78 20 33 2c 20 47 72 61 | 6d 20 73 74 61 69 6e 20 |x 3, Gra|m stain |
|00004950| 6f 66 20 62 75 66 66 79 | 20 63 6f 61 74 20 62 6c |of buffy| coat bl|
|00004960| 6f 6f 64 2c 20 54 26 43 | 20 66 6f 72 20 33 2d 36 |ood, T&C| for 3-6|
|00004970| 20 55 6e 69 74 73 20 50 | 52 42 43 2c 20 50 54 2f | Units P|RBC, PT/|
|00004980| 50 54 54 2c 20 66 69 62 | 72 69 6e 6f 67 65 6e 2c |PTT, fib|rinogen,|
|00004990| 20 46 44 50 2c 20 74 68 | 72 6f 6d 62 69 6e 20 74 | FDP, th|rombin t|
|000049a0| 69 6d 65 2c 20 67 65 6e | 74 20 6c 65 76 65 6c 73 |ime, gen|t levels|
|000049b0| 20 70 65 61 6b 20 26 20 | 74 72 6f 75 67 68 20 61 | peak & |trough a|
|000049c0| 74 20 33 72 64 20 64 6f | 73 65 2e 20 55 41 20 77 |t 3rd do|se. UA w|
|000049d0| 69 74 68 20 6d 69 63 72 | 6f 2e 20 43 75 6c 74 75 |ith micr|o. Cultu|
|000049e0| 72 65 73 20 6f 66 20 75 | 72 69 6e 65 2c 20 73 70 |res of u|rine, sp|
|000049f0| 75 74 75 6d 2c 20 77 6f | 75 6e 64 2c 20 6c 56 20 |utum, wo|und, lV |
|00004a00| 63 61 74 68 65 74 65 72 | 73 2c 20 61 73 63 69 74 |catheter|s, ascit|
|00004a10| 69 63 20 66 6c 75 69 64 | 2c 20 64 65 63 75 62 69 |ic fluid|, decubi|
|00004a20| 74 75 73 20 75 6c 63 65 | 72 73 2c 20 70 6c 65 75 |tus ulce|rs, pleu|
|00004a30| 72 61 6c 20 66 6c 75 69 | 64 20 61 73 20 69 6e 64 |ral flui|d as ind|
|00004a40| 69 63 61 74 65 64 2e 0d | 43 6f 6e 73 69 64 65 72 |icated..|Consider|
|00004a50| 20 0d 43 58 52 2c 20 4b | 55 42 2c 20 73 69 6e 75 | .CXR, K|UB, sinu|
|00004a60| 73 20 66 69 6c 6d 73 2c | 20 45 43 47 2c 20 49 6e |s films,| ECG, In|
|00004a70| 64 69 75 6d 2f 47 61 6c | 6c 69 75 6d 20 73 63 61 |dium/Gal|lium sca|
|00004a80| 6e 2c 20 75 6c 74 72 61 | 73 6f 75 6e 64 2c 20 63 |n, ultra|sound, c|
|00004a90| 6f 6e 73 69 64 65 72 20 | 6c 75 6d 62 61 72 20 70 |onsider |lumbar p|
|00004aa0| 75 6e 63 74 75 72 65 2e | 0d 54 72 65 61 74 6d 65 |uncture.|.Treatme|
|00004ab0| 6e 74 20 43 6f 6e 73 69 | 64 65 72 61 74 69 6f 6e |nt Consi|deration|
|00004ac0| 73 20 0d 2d 4f 78 79 67 | 65 6e 20 61 74 20 32 2d |s .-Oxyg|en at 2-|
|00004ad0| 35 20 4c 2f 6d 69 6e 20 | 62 79 20 4e 43 20 6f 72 |5 L/min |by NC or|
|00004ae0| 20 6d 61 73 6b 20 6f 72 | 20 6d 65 63 68 61 6e 69 | mask or| mechani|
|00004af0| 63 61 6c 20 76 65 6e 74 | 69 6c 61 74 69 6f 6e 20 |cal vent|ilation |
|00004b00| 69 66 20 69 6e 64 69 63 | 61 74 65 64 2e 0d 4e 6f |if indic|ated..No|
|00004b10| 6e 2d 69 6d 6d 75 6e 6f | 63 6f 6d 70 72 6f 6d 69 |n-immuno|compromi|
|00004b20| 73 65 64 20 41 64 75 6c | 74 73 2c 20 41 6e 74 69 |sed Adul|ts, Anti|
|00004b30| 62 69 6f 74 69 63 73 20 | 0d 69 66 20 70 65 6c 76 |biotics |.if pelv|
|00004b40| 69 63 20 6f 72 20 69 6e | 74 72 61 2d 61 62 64 6f |ic or in|tra-abdo|
|00004b50| 6d 69 6e 61 6c 20 69 6e | 66 65 63 74 69 6f 6e 2c |minal in|fection,|
|00004b60| 20 75 73 65 20 61 6d 70 | 69 63 69 6c 6c 69 6e 20 | use amp|icillin |
|00004b70| 6f 72 20 76 61 6e 63 6f | 6d 79 63 69 6e 20 77 69 |or vanco|mycin wi|
|00004b80| 74 68 20 67 65 6e 74 2f | 74 6f 62 72 61 2c 20 61 |th gent/|tobra, a|
|00004b90| 64 64 20 63 6c 69 6e 64 | 61 6d 79 63 69 6e 20 6f |dd clind|amycin o|
|00004ba0| 72 20 6d 65 74 72 6f 6e | 69 64 61 7a 6f 6c 65 20 |r metron|idazole |
|00004bb0| 3b 20 0d 4f 52 0d 2d 75 | 73 65 20 63 65 66 6f 78 |; .OR.-u|se cefox|
|00004bc0| 69 74 69 6e 20 26 20 67 | 65 6e 74 2f 74 6f 62 72 |itin & g|ent/tobr|
|00004bd0| 61 20 0d 4f 52 0d 2d 55 | 6e 61 73 79 6e 20 26 20 |a .OR.-U|nasyn & |
|00004be0| 67 65 6e 74 2f 74 6f 62 | 72 61 29 2e 20 4d 61 79 |gent/tob|ra). May|
|00004bf0| 20 75 73 65 20 33 72 64 | 20 67 65 6e 65 72 61 74 | use 3rd| generat|
|00004c00| 69 6f 6e 20 63 65 70 68 | 61 6c 6f 73 70 6f 72 69 |ion ceph|alospori|
|00004c10| 6e 73 20 69 6e 20 70 6c | 61 63 65 20 6f 66 20 61 |ns in pl|ace of a|
|00004c20| 6d 69 6e 6f 67 6c 79 63 | 6f 73 69 64 65 73 20 69 |minoglyc|osides i|
|00004c30| 66 20 72 65 73 69 73 74 | 61 6e 74 20 67 72 61 6d |f resist|ant gram|
|00004c40| 2d 6e 65 67 20 70 61 74 | 68 6f 67 65 6e 73 20 6e |-neg pat|hogens n|
|00004c50| 6f 74 20 73 75 73 70 65 | 63 74 65 64 2e 0d 2d 43 |ot suspe|cted..-C|
|00004c60| 65 66 74 61 7a 69 64 69 | 6d 65 20 28 46 6f 72 74 |eftazidi|me (Fort|
|00004c70| 61 7a 29 20 31 2d 32 20 | 67 20 49 56 20 71 38 68 |az) 1-2 |g IV q8h|
|00004c80| 20 0d 4f 52 0d 2d 43 65 | 66 74 69 7a 6f 78 69 6d | .OR.-Ce|ftizoxim|
|00004c90| 65 20 28 43 65 66 69 7a | 6f 78 29 20 31 2d 32 20 |e (Cefiz|ox) 1-2 |
|00004ca0| 67 6d 20 49 56 20 71 38 | 68 20 0d 4f 52 0d 2d 43 |gm IV q8|h .OR.-C|
|00004cb0| 65 66 6f 74 61 78 69 6d | 65 20 28 43 6c 61 66 6f |efotaxim|e (Clafo|
|00004cc0| 72 61 6e 29 20 32 20 67 | 6d 20 71 34 2d 36 68 20 |ran) 2 g|m q4-6h |
|00004cd0| 0d 4f 52 0d 2d 43 65 66 | 74 72 69 61 78 6f 6e 65 |.OR.-Cef|triaxone|
|00004ce0| 20 28 52 6f 63 65 70 68 | 69 6e 29 20 31 2d 32 20 | (Roceph|in) 1-2 |
|00004cf0| 67 6d 20 49 56 20 71 31 | 32 68 20 28 6d 61 78 20 |gm IV q1|2h (max |
|00004d00| 34 20 67 6d 2f 64 29 2e | 20 0d 4f 52 0d 2d 43 65 |4 gm/d).| .OR.-Ce|
|00004d10| 66 6f 78 69 74 69 6e 20 | 28 4d 65 66 6f 78 69 6e |foxitin |(Mefoxin|
|00004d20| 29 20 31 2d 32 20 67 6d | 73 20 71 36 2d 38 68 20 |) 1-2 gm|s q6-8h |
|00004d30| 0d 4f 52 0d 2d 43 65 66 | 6f 74 65 74 61 6e 20 28 |.OR.-Cef|otetan (|
|00004d40| 43 65 66 6f 74 61 6e 29 | 20 31 2d 32 20 47 6d 73 |Cefotan)| 1-2 Gms|
|00004d50| 20 49 56 20 71 31 32 68 | 20 0d 4f 52 0d 2d 43 65 | IV q12h| .OR.-Ce|
|00004d60| 66 6f 74 65 74 61 6e 20 | 28 43 65 66 6f 74 61 6e |fotetan |(Cefotan|
|00004d70| 29 20 31 2d 32 20 47 6d | 73 20 49 56 20 71 31 32 |) 1-2 Gm|s IV q12|
|00004d80| 68 20 0d 4f 52 0d 2d 41 | 6d 70 69 63 69 6c 6c 69 |h .OR.-A|mpicilli|
|00004d90| 6e 20 32 20 67 6d 20 49 | 56 20 71 34 68 20 0d 4f |n 2 gm I|V q4h .O|
|00004da0| 52 0d 2d 50 69 70 65 72 | 61 63 69 6c 6c 69 6e 2c |R.-Piper|acillin,|
|00004db0| 20 74 69 63 61 72 63 69 | 6c 6c 69 6e 20 6f 72 20 | ticarci|llin or |
|00004dc0| 6d 65 7a 6c 6f 63 69 6c | 6c 69 6e 20 33 20 67 6d |mezlocil|lin 3 gm|
|00004dd0| 73 20 49 56 20 71 34 2d | 36 68 20 0d 41 4e 44 0d |s IV q4-|6h .AND.|
|00004de0| 2d 47 65 6e 74 61 6d 69 | 63 69 6e 20 6f 72 20 74 |-Gentami|cin or t|
|00004df0| 6f 62 72 61 6d 79 63 69 | 6e 20 31 30 30 2d 31 32 |obramyci|n 100-12|
|00004e00| 30 20 6d 67 20 28 31 2e | 35 2d 32 20 6d 67 2f 6b |0 mg (1.|5-2 mg/k|
|00004e10| 67 29 20 49 56 2c 20 74 | 68 65 6e 20 38 30 20 6d |g) IV, t|hen 80 m|
|00004e20| 67 20 49 56 20 71 38 68 | 20 28 33 2d 35 20 6d 67 |g IV q8h| (3-5 mg|
|00004e30| 2f 6b 67 2f 64 29 20 0d | 41 4e 44 0d 2d 43 6c 69 |/kg/d) .|AND.-Cli|
|00004e40| 6e 64 61 6d 79 63 69 6e | 20 36 30 30 2d 39 30 30 |ndamycin| 600-900|
|00004e50| 20 49 56 20 71 38 68 20 | 28 31 35 2d 33 30 20 6d | IV q8h |(15-30 m|
|00004e60| 67 2f 6b 67 2f 64 29 20 | 0d 4f 52 0d 2d 4d 65 74 |g/kg/d) |.OR.-Met|
|00004e70| 72 6f 6e 69 64 61 7a 6f | 6c 65 20 35 30 30 20 6d |ronidazo|le 500 m|
|00004e80| 67 20 28 37 2e 35 20 6d | 67 2f 6b 67 29 20 49 56 |g (7.5 m|g/kg) IV|
|00004e90| 20 71 36 68 20 0d 4f 52 | 0d 2d 50 69 70 65 72 61 | q6h .OR|.-Pipera|
|00004ea0| 63 69 6c 6c 69 6e 2f 74 | 61 7a 6f 62 61 63 74 61 |cillin/t|azobacta|
|00004eb0| 6d 20 28 5a 6f 73 79 6e | 29 20 33 2e 33 37 35 20 |m (Zosyn|) 3.375 |
|00004ec0| 67 6d 20 49 56 20 71 36 | 68 20 0d 4f 52 0d 2d 54 |gm IV q6|h .OR.-T|
|00004ed0| 69 63 61 72 63 69 6c 6c | 69 6e 2f 63 6c 61 76 75 |icarcill|in/clavu|
|00004ee0| 6c 61 6e 69 63 20 61 63 | 69 64 20 28 54 69 6d 65 |lanic ac|id (Time|
|00004ef0| 6e 74 69 6e 29 20 33 2e | 31 20 67 6d 20 49 56 20 |ntin) 3.|1 gm IV |
|00004f00| 71 34 2d 36 68 20 28 32 | 30 30 2d 33 30 30 20 6d |q4-6h (2|00-300 m|
|00004f10| 67 2f 6b 67 2f 64 29 20 | 28 77 69 74 68 20 67 65 |g/kg/d) |(with ge|
|00004f20| 6e 74 2f 74 6f 62 72 61 | 29 2e 20 0d 4f 52 0d 2d |nt/tobra|). .OR.-|
|00004f30| 41 6d 70 69 63 69 6c 6c | 69 6e 2f 53 75 6c 62 61 |Ampicill|in/Sulba|
|00004f40| 63 74 61 6d 20 28 55 6e | 61 73 79 6e 29 20 31 2e |ctam (Un|asyn) 1.|
|00004f50| 35 2d 33 2e 30 20 67 6d | 20 49 56 20 71 36 68 20 |5-3.0 gm| IV q6h |
|00004f60| 28 77 69 74 68 20 67 65 | 6e 74 2f 74 6f 62 72 61 |(with ge|nt/tobra|
|00004f70| 29 20 0d 4f 52 0d 2d 49 | 6d 69 70 65 6e 65 6d 2f |) .OR.-I|mipenem/|
|00004f80| 63 69 6c 61 73 74 61 74 | 69 6e 20 28 50 72 69 6d |cilastat|in (Prim|
|00004f90| 61 78 69 6e 29 20 30 2e | 35 2d 31 2e 30 20 67 6d |axin) 0.|5-1.0 gm|
|00004fa0| 20 49 56 20 71 36 2d 38 | 68 20 28 77 69 74 68 20 | IV q6-8|h (with |
|00004fb0| 67 65 6e 74 2f 74 6f 62 | 72 61 29 2e 0d 2d 56 61 |gent/tob|ra)..-Va|
|00004fc0| 6e 63 6f 6d 79 63 69 6e | 20 35 30 30 20 6d 67 20 |ncomycin| 500 mg |
|00004fd0| 49 56 20 71 36 68 20 6f | 72 20 31 20 67 6d 20 49 |IV q6h o|r 1 gm I|
|00004fe0| 56 20 71 31 32 68 2e 0d | 4e 6f 73 6f 63 6f 6d 69 |V q12h..|Nosocomi|
|00004ff0| 61 6c 20 73 65 70 73 69 | 73 20 77 69 74 68 20 49 |al sepsi|s with I|
|00005000| 56 20 63 61 74 68 65 74 | 65 72 20 6f 72 20 49 56 |V cathet|er or IV|
|00005010| 20 64 72 75 67 20 61 62 | 75 73 65 0d 2d 56 61 6e | drug ab|use.-Van|
|00005020| 63 6f 6d 79 63 69 6e 20 | 35 30 30 20 6d 67 20 49 |comycin |500 mg I|
|00005030| 56 20 71 36 68 20 6f 72 | 20 31 20 67 6d 20 71 31 |V q6h or| 1 gm q1|
|00005040| 32 68 20 28 31 20 67 6d | 20 69 6e 20 32 35 30 20 |2h (1 gm| in 250 |
|00005050| 63 63 20 44 35 57 20 6f | 76 65 72 20 36 30 20 6d |cc D5W o|ver 60 m|
|00005060| 69 6e 20 71 31 32 68 29 | 3b 20 0d 41 4e 44 0d 47 |in q12h)|; .AND.G|
|00005070| 65 6e 74 61 6d 69 63 69 | 6e 20 6f 72 20 54 6f 62 |entamici|n or Tob|
|00005080| 72 61 6d 79 63 69 6e 20 | 61 73 20 61 62 6f 76 65 |ramycin |as above|
|00005090| 3b 20 0d 41 4e 44 20 45 | 49 54 48 45 52 0d 43 65 |; .AND E|ITHER.Ce|
|000050a0| 66 74 61 7a 69 64 69 6d | 65 20 6f 72 20 43 65 66 |ftazidim|e or Cef|
|000050b0| 74 69 7a 6f 78 69 6d 65 | 20 31 2d 32 20 67 6d 73 |tizoxime| 1-2 gms|
|000050c0| 20 49 56 20 71 38 68 20 | 0d 4f 52 0d 50 69 70 65 | IV q8h |.OR.Pipe|
|000050d0| 72 61 63 69 6c 6c 69 6e | 2c 20 74 69 63 61 72 63 |racillin|, ticarc|
|000050e0| 69 6c 6c 69 6e 20 6f 72 | 20 6d 65 7a 6c 6f 63 69 |illin or| mezloci|
|000050f0| 6c 6c 69 6e 20 33 20 67 | 6d 20 49 56 20 71 34 2d |llin 3 g|m IV q4-|
|00005100| 36 68 2e 00 00 00 20 41 | 00 00 00 00 00 00 0d 05 |6h.... A|........|
|00005110| 00 00 00 00 00 00 09 b4 | 00 00 10 e4 00 00 17 38 |........|.......8|
|00005120| 00 00 1e 98 00 00 28 43 | 00 00 00 00 00 00 50 cd |......(C|......P.|
|00005130| 00 00 50 fd 00 00 51 3d | 00 00 11 75 00 00 50 fd |..P...Q=|...u..P.|
|00005140| 00 00 06 2c 00 00 52 9d | 00 00 5e 25 00 00 2c 41 |...,..R.|..^%..,A|
|00005150| 00 00 00 00 00 00 00 00 | 00 00 00 02 00 00 02 dd |........|........|
|00005160| 00 00 03 15 00 00 0e 7d | 00 00 05 25 00 00 0e 95 |.......}|...%....|
|00005170| 00 00 0e b5 00 00 0e cd | ad ba db ad 00 00 3c 40 |........|......<@|
|00005180| 00 00 00 00 00 00 03 e5 | 00 53 00 55 00 42 00 41 |........|.S.U.B.A|
|00005190| 00 52 00 41 00 43 00 48 | 00 4e 00 4f 00 49 00 44 |.R.A.C.H|.N.O.I.D|
|000051a0| 00 20 00 48 00 45 00 4d | 00 4f 00 52 00 52 00 48 |. .H.E.M|.O.R.R.H|
|000051b0| 00 41 00 47 00 45 00 00 | ad ba db ad 00 01 5c 41 |.A.G.E..|......\A|
|000051c0| 00 00 00 00 00 00 0d 05 | 00 00 00 64 00 00 10 a5 |........|...d....|
|000051d0| 00 00 00 04 00 00 11 3d | 00 00 00 38 00 00 10 a5 |.......=|...8....|
|000051e0| 00 00 01 54 00 00 11 3d | 00 00 00 2c 00 00 10 a5 |...T...=|...,....|
|000051f0| 00 00 03 fc 00 00 11 3d | 00 00 00 60 00 00 10 a5 |.......=|...`....|
|00005200| 00 00 00 d8 00 00 11 3d | 00 00 00 6c 00 00 10 a5 |.......=|...l....|
|00005210| 00 00 03 80 00 00 11 3d | 00 00 00 68 00 00 10 a5 |.......=|...h....|
|00005220| 00 00 05 38 00 00 11 3d | 00 00 00 38 00 00 10 a5 |...8...=|...8....|
|00005230| 00 00 01 ec 00 00 11 3d | 00 00 00 28 00 00 10 a5 |.......=|...(....|
|00005240| 00 00 02 74 00 00 11 3d | 00 00 00 08 00 00 10 a5 |...t...=|........|
|00005250| 00 00 01 b0 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|00005260| 00 00 04 4c 00 00 11 3d | 00 00 01 10 00 00 10 a5 |...L...=|........|
|00005270| 00 00 00 04 00 00 11 3d | 00 00 00 64 00 00 10 a5 |.......=|...d....|
|00005280| 00 00 02 34 00 00 11 3d | 00 00 00 08 00 00 10 a5 |...4...=|........|
|00005290| 00 00 00 e0 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|000052a0| 00 00 00 dc 00 00 11 3d | 00 00 00 08 00 00 10 a5 |.......=|........|
|000052b0| 00 00 01 e0 00 00 11 3d | 00 00 00 58 00 00 10 a5 |.......=|...X....|
|000052c0| 00 00 01 68 00 00 11 3d | 00 00 00 4c 00 00 10 a5 |...h...=|...L....|
|000052d0| 00 00 01 00 00 00 11 3d | 00 00 00 7c 00 00 10 a5 |.......=|...|....|
|000052e0| 00 00 01 40 00 00 11 3d | 00 00 00 3c 00 00 10 a5 |...@...=|...<....|
|000052f0| 00 00 02 34 00 00 11 3d | 00 00 00 30 00 00 10 a5 |...4...=|...0....|
|00005300| 00 00 01 c8 00 00 11 3d | 00 00 00 50 00 00 10 a5 |.......=|...P....|
|00005310| 00 00 01 58 00 00 11 3d | ad ba db ad 00 0b 85 40 |...X...=|.......@|
|00005320| 00 00 00 00 00 00 03 e5 | 53 61 63 63 75 6c 61 72 |........|Saccular|
|00005330| 20 41 6e 65 75 72 79 73 | 6d 20 52 75 70 74 75 72 | Aneurys|m Ruptur|
|00005340| 65 0d 50 72 65 73 65 6e | 74 61 74 69 6f 6e 20 0d |e.Presen|tation .|
|00005350| 57 6f 72 73 74 20 68 65 | 61 64 61 63 68 65 20 65 |Worst he|adache e|
|00005360| 76 65 72 2c 20 6e 61 75 | 73 65 61 2f 76 6f 6d 69 |ver, nau|sea/vomi|
|00005370| 74 69 6e 67 2c 20 6d 79 | 64 72 69 61 73 69 73 2f |ting, my|driasis/|
|00005380| 76 69 73 75 61 6c 20 66 | 69 65 6c 64 20 64 65 66 |visual f|ield def|
|00005390| 65 63 74 73 2c 20 70 61 | 72 65 73 69 73 2c 20 63 |ects, pa|resis, c|
|000053a0| 6f 6d 61 2e 0d 44 69 61 | 67 6e 6f 73 69 73 20 0d |oma..Dia|gnosis .|
|000053b0| 4e 6f 6e 63 6f 6e 74 72 | 61 73 74 20 68 65 61 64 |Noncontr|ast head|
|000053c0| 20 43 54 20 28 66 69 72 | 73 74 20 6c 69 6e 65 20 | CT (fir|st line |
|000053d0| 69 66 20 61 76 61 69 6c | 61 62 6c 65 29 3b 20 69 |if avail|able); i|
|000053e0| 66 20 43 54 20 6e 6f 6e | 2d 64 69 61 67 6e 6f 73 |f CT non|-diagnos|
|000053f0| 74 69 63 20 77 69 74 68 | 20 68 69 67 68 20 73 75 |tic with| high su|
|00005400| 73 70 69 63 69 6f 6e 2c | 20 70 65 72 66 6f 72 6d |spicion,| perform|
|00005410| 20 6c 75 6d 62 61 72 20 | 70 75 6e 63 74 75 72 65 | lumbar |puncture|
|00005420| 20 2d 20 78 61 6e 74 68 | 6f 63 68 72 6f 6d 69 61 | - xanth|ochromia|
|00005430| 2f 75 6e 69 66 6f 72 6d | 20 63 65 6c 6c 20 63 6f |/uniform| cell co|
|00005440| 75 6e 74 3b 20 63 65 72 | 65 62 72 61 6c 20 61 72 |unt; cer|ebral ar|
|00005450| 74 65 72 69 6f 67 72 61 | 70 68 79 20 66 6f 72 20 |teriogra|phy for |
|00005460| 73 75 72 67 65 72 79 3b | 20 50 54 2f 50 54 54 2c |surgery;| PT/PTT,|
|00005470| 20 43 42 43 3b 20 66 75 | 6e 64 6f 73 63 6f 70 79 | CBC; fu|ndoscopy|
|00005480| 20 73 75 70 70 6f 72 74 | 69 76 65 20 28 72 65 74 | support|ive (ret|
|00005490| 69 6e 61 6c 20 68 65 6d | 6f 72 72 68 61 67 65 73 |inal hem|orrhages|
|000054a0| 2f 70 61 70 69 6c 6c 65 | 64 65 6d 61 29 2e 0d 44 |/papille|dema)..D|
|000054b0| 69 66 66 65 72 65 6e 74 | 69 61 6c 20 44 69 61 67 |ifferent|ial Diag|
|000054c0| 6e 6f 73 69 73 20 0d 49 | 6e 74 72 61 63 65 72 65 |nosis .I|ntracere|
|000054d0| 62 72 61 6c 20 68 65 6d | 6f 72 72 68 61 67 65 2c |bral hem|orrhage,|
|000054e0| 20 73 75 62 64 75 72 61 | 6c 2f 65 70 69 64 75 72 | subdura|l/epidur|
|000054f0| 61 6c 20 68 65 6d 61 74 | 6f 6d 61 2e 0d 44 69 61 |al hemat|oma..Dia|
|00005500| 67 6e 6f 73 74 69 63 20 | 43 6f 6e 73 69 64 65 72 |gnostic |Consider|
|00005510| 61 74 69 6f 6e 73 20 0d | 43 42 43 2c 20 53 4d 41 |ations .|CBC, SMA|
|00005520| 20 31 32 2c 20 6c 69 70 | 69 64 20 70 72 6f 66 69 | 12, lip|id profi|
|00005530| 6c 65 2c 20 62 6c 6f 6f | 64 20 43 26 53 20 78 20 |le, bloo|d C&S x |
|00005540| 32 2c 20 56 44 52 4c 2c | 20 46 54 41 2c 20 45 53 |2, VDRL,| FTA, ES|
|00005550| 52 2c 20 55 41 2c 20 4c | 46 54 27 73 2c 20 68 65 |R, UA, L|FT's, he|
|00005560| 70 61 74 69 74 69 73 20 | 70 61 6e 65 6c 2e 20 43 |patitis |panel. C|
|00005570| 58 52 2c 20 45 43 47 2c | 20 43 54 20 77 69 74 68 |XR, ECG,| CT with|
|00005580| 6f 75 74 20 63 6f 6e 74 | 72 61 73 74 2c 20 4d 52 |out cont|rast, MR|
|00005590| 49 20 77 69 74 68 20 6f | 72 20 77 69 74 68 6f 75 |I with o|r withou|
|000055a0| 74 20 67 61 64 6f 6c 69 | 6e 69 75 6d 2c 20 63 61 |t gadoli|nium, ca|
|000055b0| 72 6f 74 69 64 20 64 75 | 70 6c 65 78 2c 20 74 72 |rotid du|plex, tr|
|000055c0| 61 6e 73 63 72 61 6e 69 | 61 6c 20 44 6f 70 70 6c |anscrani|al Doppl|
|000055d0| 65 72 2c 20 63 65 72 65 | 62 72 61 6c 20 61 6e 67 |er, cere|bral ang|
|000055e0| 69 6f 67 72 61 6d 2c 20 | 65 63 68 6f 63 61 72 64 |iogram, |echocard|
|000055f0| 69 6f 67 72 61 6d 2e 0d | 54 72 65 61 74 6d 65 6e |iogram..|Treatmen|
|00005600| 74 20 43 6f 6e 73 69 64 | 65 72 61 74 69 6f 6e 73 |t Consid|erations|
|00005610| 20 0d 31 2e 20 4e 65 75 | 72 6f 6c 6f 67 79 2c 20 | .1. Neu|rology, |
|00005620| 6e 65 75 72 6f 73 75 72 | 67 69 63 61 6c 20 63 6f |neurosur|gical co|
|00005630| 6e 73 75 6c 74 73 2e 0d | 32 2e 20 41 76 6f 69 64 |nsults..|2. Avoid|
|00005640| 20 73 74 69 6d 75 6c 61 | 74 69 6f 6e 3b 20 6b 65 | stimula|tion; ke|
|00005650| 65 70 20 72 6f 6f 6d 20 | 64 61 72 6b 20 61 6e 64 |ep room |dark and|
|00005660| 20 71 75 69 65 74 3b 20 | 6e 6f 20 72 65 63 74 61 | quiet; |no recta|
|00005670| 6c 20 65 78 61 6d 20 6f | 72 20 6c 75 6d 62 61 72 |l exam o|r lumbar|
|00005680| 20 70 75 6e 63 74 75 72 | 65 3b 20 63 6f 6e 73 69 | punctur|e; consi|
|00005690| 64 65 72 20 63 65 72 65 | 62 72 61 6c 20 61 6e 67 |der cere|bral ang|
|000056a0| 69 6f 67 72 61 70 68 79 | 2e 0d 33 2e 20 4e 69 6d |iography|..3. Nim|
|000056b0| 6f 64 69 70 69 6e 65 20 | 28 4e 69 6d 6f 74 6f 70 |odipine |(Nimotop|
|000056c0| 29 20 36 30 20 6d 67 20 | 50 4f 20 6f 72 20 76 69 |) 60 mg |PO or vi|
|000056d0| 61 20 4e 47 20 74 75 62 | 65 20 71 34 68 20 78 20 |a NG tub|e q4h x |
|000056e0| 32 31 20 64 61 79 73 2c | 20 73 74 61 72 74 20 61 |21 days,| start a|
|000056f0| 73 20 73 6f 6f 6e 20 61 | 73 20 70 6f 73 73 69 62 |s soon a|s possib|
|00005700| 6c 65 20 28 77 69 74 68 | 69 6e 20 39 36 20 68 6f |le (with|in 96 ho|
|00005710| 75 72 73 29 2e 0d 34 2e | 20 53 74 6f 6f 6c 20 73 |urs)..4.| Stool s|
|00005720| 6f 66 74 65 6e 65 72 73 | 2c 20 44 56 54 20 70 72 |ofteners|, DVT pr|
|00005730| 6f 70 68 79 6c 61 78 69 | 73 20 77 69 74 68 20 70 |ophylaxi|s with p|
|00005740| 6e 65 75 6d 61 74 69 63 | 20 63 6f 6d 70 72 65 73 |neumatic| compres|
|00005750| 73 69 6f 6e 20 73 74 6f | 63 6b 69 6e 67 73 2e 0d |sion sto|ckings..|
|00005760| 50 61 69 6e 20 43 6f 6e | 74 72 6f 6c 20 0d 63 6f |Pain Con|trol .co|
|00005770| 64 65 69 6e 65 20 31 35 | 20 74 6f 20 36 30 20 6d |deine 15| to 60 m|
|00005780| 67 20 71 34 2d 36 68 20 | 2d 20 77 69 74 68 6f 75 |g q4-6h |- withou|
|00005790| 74 20 65 78 63 65 73 73 | 69 76 65 20 73 65 64 61 |t excess|ive seda|
|000057a0| 74 69 6f 6e 20 74 6f 20 | 6d 61 73 6b 20 6d 65 6e |tion to |mask men|
|000057b0| 74 61 6c 20 73 74 61 74 | 75 73 3b 20 61 69 72 77 |tal stat|us; airw|
|000057c0| 61 79 20 63 6f 6e 74 72 | 6f 6c 20 77 69 74 68 20 |ay contr|ol with |
|000057d0| 69 6e 74 75 62 61 74 69 | 6f 6e 20 61 73 20 6e 65 |intubati|on as ne|
|000057e0| 63 65 73 73 61 72 79 2e | 0d 43 6f 6e 73 69 64 65 |cessary.|.Conside|
|000057f0| 72 20 0d 2d 44 65 78 61 | 6d 65 74 68 61 73 6f 6e |r .-Dexa|methason|
|00005800| 65 20 28 44 65 63 61 64 | 72 6f 6e 29 20 31 30 20 |e (Decad|ron) 10 |
|00005810| 6d 67 20 49 56 20 6f 72 | 20 49 4d 20 2c 20 66 6f |mg IV or| IM , fo|
|00005820| 6c 6c 6f 77 65 64 20 62 | 79 20 34 20 6d 67 20 49 |llowed b|y 4 mg I|
|00005830| 56 2c 20 49 4d 20 6f 72 | 20 50 4f 20 71 36 68 2e |V, IM or| PO q6h.|
|00005840| 0d 2d 4e 69 74 72 6f 70 | 72 75 73 73 69 64 65 20 |.-Nitrop|russide |
|00005850| 73 6f 64 69 75 6d 2c 20 | 30 2e 31 2d 31 30 2e 30 |sodium, |0.1-10.0|
|00005860| 20 6d 69 63 72 6f 20 67 | 2f 6b 67 2f 6d 69 6e 20 | micro g|/kg/min |
|00005870| 28 35 30 2d 32 30 30 20 | 6d 67 2f 32 35 30 20 6d |(50-200 |mg/250 m|
|00005880| 6c 20 4e 53 29 2c 20 74 | 69 74 72 61 74 65 20 0d |l NS), t|itrate .|
|00005890| 4f 52 0d 2d 50 72 6f 70 | 72 61 6e 6f 6c 6f 6c 20 |OR.-Prop|ranolol |
|000058a0| 31 2d 33 20 6d 67 20 49 | 56 20 71 36 68 20 6f 72 |1-3 mg I|V q6h or|
|000058b0| 20 31 30 2d 36 30 20 6d | 67 20 50 4f 20 71 69 64 | 10-60 m|g PO qid|
|000058c0| 2c 20 74 69 74 72 61 74 | 65 20 74 6f 20 42 50 20 |, titrat|e to BP |
|000058d0| 3c 31 36 30 2f 39 30 2c | 20 61 76 6f 69 64 20 69 |<160/90,| avoid i|
|000058e0| 66 20 68 79 70 6f 74 65 | 6e 73 69 76 65 20 6f 72 |f hypote|nsive or|
|000058f0| 20 62 72 61 64 79 63 61 | 72 64 69 63 20 0d 4f 52 | bradyca|rdic .OR|
|00005900| 0d 2d 4c 61 62 65 74 61 | 6c 6f 6c 20 28 4e 6f 72 |.-Labeta|lol (Nor|
|00005910| 6d 6f 64 79 6e 65 29 20 | 32 30 2d 38 30 20 6d 67 |modyne) |20-80 mg|
|00005920| 20 49 56 20 6f 76 65 72 | 20 32 20 6d 69 6e 2c 20 | IV over| 2 min, |
|00005930| 71 31 30 2d 31 35 20 6d | 69 6e 2c 20 6f 72 20 69 |q10-15 m|in, or i|
|00005940| 6e 66 75 73 65 20 30 2e | 35 2d 32 2e 30 20 6d 67 |nfuse 0.|5-2.0 mg|
|00005950| 2f 6d 69 6e 0d 2d 50 68 | 65 6e 79 74 6f 69 6e 20 |/min.-Ph|enytoin |
|00005960| 28 69 66 20 73 65 69 7a | 75 72 65 29 20 49 56 20 |(if seiz|ure) IV |
|00005970| 6c 6f 61 64 20 31 35 20 | 2d 20 32 30 20 6d 67 2f |load 15 |- 20 mg/|
|00005980| 6b 67 20 49 56 20 69 6e | 20 4e 53 20 28 69 6e 66 |kg IV in| NS (inf|
|00005990| 75 73 65 20 61 74 20 6d | 61 78 20 35 30 20 6d 67 |use at m|ax 50 mg|
|000059a0| 2f 6d 69 6e 29 2c 20 74 | 68 65 6e 20 33 30 30 20 |/min), t|hen 300 |
|000059b0| 6d 67 20 50 4f 2f 49 56 | 20 71 41 4d 20 6f 72 20 |mg PO/IV| qAM or |
|000059c0| 32 30 30 20 6d 67 20 71 | 31 32 68 28 34 2d 36 20 |200 mg q|12h(4-6 |
|000059d0| 6d 67 2f 6b 67 2f 64 29 | 2e 0d 2d 43 6f 64 65 69 |mg/kg/d)|..-Codei|
|000059e0| 6e 65 20 33 30 2d 36 30 | 20 6d 67 20 50 4f 2c 20 |ne 30-60| mg PO, |
|000059f0| 49 4d 2c 20 49 56 2c 20 | 6f 72 20 53 51 20 71 34 |IM, IV, |or SQ q4|
|00005a00| 2d 36 68 20 70 72 6e 20 | 68 65 61 64 20 70 61 69 |-6h prn |head pai|
|00005a10| 6e 2e 0d 49 6e 63 72 65 | 61 73 65 64 20 69 6e 74 |n..Incre|ased int|
|00005a20| 72 61 63 72 61 6e 69 61 | 6c 20 70 72 65 73 73 75 |racrania|l pressu|
|00005a30| 72 65 20 73 65 65 20 49 | 4e 43 52 45 41 53 45 44 |re see I|NCREASED|
|00005a40| 20 49 4e 54 52 41 43 52 | 41 4e 49 41 4c 20 50 52 | INTRACR|ANIAL PR|
|00005a50| 45 53 53 55 52 45 2e 0d | 53 79 6d 70 74 6f 6d 61 |ESSURE..|Symptoma|
|00005a60| 74 69 63 20 4d 65 64 69 | 63 61 74 69 6f 6e 73 20 |tic Medi|cations |
|00005a70| 0d 2d 41 63 65 74 61 6d | 69 6e 6f 70 68 65 6e 20 |.-Acetam|inophen |
|00005a80| 31 2d 32 20 74 61 62 73 | 20 50 4f 20 71 20 34 2d |1-2 tabs| PO q 4-|
|00005a90| 36 68 20 70 72 6e 20 68 | 65 61 64 61 63 68 65 2e |6h prn h|eadache.|
|00005aa0| 0d 2d 44 6f 63 75 73 61 | 74 65 20 73 6f 64 69 75 |.-Docusa|te sodiu|
|00005ab0| 6d 20 28 43 6f 6c 61 63 | 65 29 20 31 30 30 2d 32 |m (Colac|e) 100-2|
|00005ac0| 30 30 20 6d 67 20 50 4f | 20 71 68 73 2e 0d 2d 4d |00 mg PO| qhs..-M|
|00005ad0| 69 6c 6b 20 6f 66 20 6d | 61 67 6e 65 73 69 61 20 |ilk of m|agnesia |
|00005ae0| 33 30 20 6d 6c 20 50 4f | 20 71 64 20 70 72 6e 20 |30 ml PO| qd prn |
|00005af0| 63 6f 6e 73 74 69 70 61 | 74 69 6f 6e 20 0d 4f 52 |constipa|tion .OR|
|00005b00| 0d 2d 42 69 73 61 63 6f | 64 79 6c 20 28 44 75 6c |.-Bisaco|dyl (Dul|
|00005b10| 63 6f 6c 61 78 29 20 31 | 30 2d 31 35 20 6d 67 20 |colax) 1|0-15 mg |
|00005b20| 50 4f 20 71 68 73 20 6f | 72 20 31 30 20 6d 67 20 |PO qhs o|r 10 mg |
|00005b30| 50 52 20 70 72 6e 20 0d | 4f 52 0d 2d 52 61 6e 69 |PR prn .|OR.-Rani|
|00005b40| 74 69 64 69 6e 65 20 28 | 5a 61 6e 74 61 63 29 20 |tidine (|Zantac) |
|00005b50| 35 30 20 6d 67 20 49 56 | 20 71 36 2d 38 68 20 6f |50 mg IV| q6-8h o|
|00005b60| 72 20 31 35 30 20 6d 67 | 20 50 4f 20 62 69 64 20 |r 150 mg| PO bid |
|00005b70| 0d 4f 52 0d 2d 43 69 6d | 65 74 69 64 69 6e 65 20 |.OR.-Cim|etidine |
|00005b80| 28 54 61 67 61 6d 65 74 | 29 20 33 30 30 20 6d 67 |(Tagamet|) 300 mg|
|00005b90| 20 49 56 20 71 36 2d 38 | 68 20 6f 72 20 33 30 30 | IV q6-8|h or 300|
|00005ba0| 20 6d 67 20 50 4f 20 74 | 69 64 2d 71 69 64 2e 0d | mg PO t|id-qid..|
|00005bb0| 2d 41 63 65 74 61 6d 69 | 6e 6f 70 68 65 6e 20 33 |-Acetami|nophen 3|
|00005bc0| 32 35 20 6d 67 20 31 2d | 32 20 74 61 62 73 20 50 |25 mg 1-|2 tabs P|
|00005bd0| 4f 2f 50 52 20 71 34 2d | 36 68 20 70 72 6e 20 74 |O/PR q4-|6h prn t|
|00005be0| 65 6d 70 20 3e 20 31 30 | 30 2e 0d 53 75 72 67 69 |emp > 10|0..Surgi|
|00005bf0| 63 61 6c 20 49 6e 64 69 | 63 61 74 69 6f 6e 73 20 |cal Indi|cations |
|00005c00| 0d 68 69 67 68 20 72 61 | 74 65 20 6f 66 20 72 65 |.high ra|te of re|
|00005c10| 62 6c 65 65 64 69 6e 67 | 2c 20 76 65 6e 74 72 69 |bleeding|, ventri|
|00005c20| 63 75 6c 61 72 20 64 72 | 61 69 6e 61 67 65 20 66 |cular dr|ainage f|
|00005c30| 6f 72 20 68 79 64 72 6f | 63 65 70 68 61 6c 75 73 |or hydro|cephalus|
|00005c40| 20 75 6e 72 65 73 70 6f | 6e 73 69 76 65 20 74 6f | unrespo|nsive to|
|00005c50| 20 64 69 75 72 65 73 69 | 73 2e 0d 43 65 72 65 62 | diuresi|s..Cereb|
|00005c60| 72 61 6c 20 49 73 63 68 | 65 6d 69 61 20 0d 4e 69 |ral Isch|emia .Ni|
|00005c70| 6d 6f 64 69 70 69 6e 65 | 20 36 30 20 6d 67 20 71 |modipine| 60 mg q|
|00005c80| 34 68 20 66 6f 72 20 32 | 31 20 64 61 79 73 2c 20 |4h for 2|1 days, |
|00005c90| 73 74 61 72 74 20 61 74 | 20 6f 6e 73 65 74 20 6f |start at| onset o|
|00005ca0| 66 20 68 65 6d 6f 72 72 | 68 61 67 65 2e 0d 53 65 |f hemorr|hage..Se|
|00005cb0| 69 7a 75 72 65 20 50 72 | 6f 70 68 79 6c 61 78 69 |izure Pr|ophylaxi|
|00005cc0| 73 2f 54 72 65 61 74 6d | 65 6e 74 20 0d 50 68 65 |s/Treatm|ent .Phe|
|00005cd0| 6e 79 74 6f 69 6e 20 31 | 35 20 2d 20 32 30 20 6d |nytoin 1|5 - 20 m|
|00005ce0| 67 2f 6b 67 20 49 56 20 | 6c 6f 61 64 20 4e 53 20 |g/kg IV |load NS |
|00005cf0| 66 6f 6c 6c 6f 77 65 64 | 20 62 79 20 34 20 2d 20 |followed| by 4 - |
|00005d00| 36 20 6d 67 2f 6b 67 2f | 64 61 79 2c 20 6d 6f 6e |6 mg/kg/|day, mon|
|00005d10| 69 74 6f 72 20 6c 65 76 | 65 6c 73 2e 0d 48 79 64 |itor lev|els..Hyd|
|00005d20| 72 6f 63 65 70 68 61 6c | 75 73 20 0d 69 6e 69 74 |rocephal|us .init|
|00005d30| 69 61 6c 20 75 73 65 20 | 6f 66 20 6d 61 6e 6e 69 |ial use |of manni|
|00005d40| 74 6f 6c 20 31 20 67 6d | 2f 6b 67 2c 20 74 68 65 |tol 1 gm|/kg, the|
|00005d50| 6e 20 30 2e 32 35 20 67 | 6d 2f 6b 67 20 49 56 20 |n 0.25 g|m/kg IV |
|00005d60| 71 69 64 20 2d 20 6d 6f | 6e 69 74 6f 72 20 65 6c |qid - mo|nitor el|
|00005d70| 65 63 74 72 6f 6c 79 74 | 65 73 2e 20 43 6f 6e 74 |ectrolyt|es. Cont|
|00005d80| 72 6f 76 65 72 73 69 61 | 6c 20 2d 20 44 65 78 61 |roversia|l - Dexa|
|00005d90| 6d 65 74 68 61 73 6f 6e | 65 20 31 30 20 6d 67 20 |methason|e 10 mg |
|00005da0| 49 56 20 66 6f 6c 6c 6f | 77 65 64 20 62 79 20 34 |IV follo|wed by 4|
|00005db0| 20 6d 67 20 71 36 68 2e | 0d 42 50 20 43 6f 6e 74 | mg q6h.|.BP Cont|
|00005dc0| 72 6f 6c 20 0d 61 76 6f | 69 64 20 68 79 70 6f 74 |rol .avo|id hypot|
|00005dd0| 65 6e 73 69 6f 6e 2c 20 | 6b 65 65 70 20 4d 41 50 |ension, |keep MAP|
|00005de0| 20 39 30 20 2d 20 31 30 | 30 20 6d 6d 48 67 3b 20 | 90 - 10|0 mmHg; |
|00005df0| 4c 61 62 65 74 61 6c 6f | 6c 20 32 30 20 2d 20 36 |Labetalo|l 20 - 6|
|00005e00| 30 20 6d 67 20 49 56 50 | 20 71 31 35 6d 69 6e 20 |0 mg IVP| q15min |
|00005e10| 6f 72 20 63 6f 6e 73 74 | 61 6e 74 20 69 6e 66 75 |or const|ant infu|
|00005e20| 73 69 6f 6e 20 30 2e 35 | 20 2d 20 32 2e 30 20 6d |sion 0.5| - 2.0 m|
|00005e30| 67 2f 6d 69 6e 2e 0d 44 | 69 61 62 65 74 65 73 20 |g/min..D|iabetes |
|00005e40| 49 6e 73 69 70 69 64 75 | 73 20 0d 74 72 69 61 6c |Insipidu|s .trial|
|00005e50| 20 6f 66 20 44 44 41 56 | 50 20 32 20 2d 20 34 20 | of DDAV|P 2 - 4 |
|00005e60| 6d 63 67 20 49 56 2f 53 | 51 20 71 31 32 68 3b 20 |mcg IV/S|Q q12h; |
|00005e70| 6d 6f 6e 69 74 6f 72 20 | 69 6e 70 75 74 2f 6f 75 |monitor |input/ou|
|00005e80| 74 70 75 74 20 61 6e 64 | 20 75 72 69 6e 65 20 73 |tput and| urine s|
|00005e90| 70 65 63 69 66 69 63 20 | 67 72 61 76 69 74 79 2e |pecific |gravity.|
|00005ea0| 00 ba db ad 00 00 24 41 | 00 00 00 00 00 00 0d 05 |......$A|........|
|00005eb0| 00 00 00 00 00 00 09 44 | 00 00 13 2c 00 00 1c c0 |.......D|...,....|
|00005ec0| 00 00 24 2c 00 00 2d 40 | ad ba db ad 00 00 28 41 |..$,..-@|......(A|
|00005ed0| 00 00 00 00 00 00 5e 75 | 00 00 00 02 00 00 00 02 |......^u|........|
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