I would like to introduce a project I have been working on (off and on) for a couple of years.
This is a web based App aimed at delivering the pathway for paracetamol overdose (Acetylcysteine pathway) and is a small part of ongoing work to operationalize the different classes of pathways as proposed by @karen.j.green.
This pathway appeared prime for an IT solution because of the maths required for first establishing if treatment is indicated and second calculating the dose, volume and rate of three infusions. There are plenty of opportunities for error particularly if the practitioner is not mathematically adept.
The App is a prototype only, I have built it as an HTML with JqueryUI to make user input and charting nicer. At the moment it is entirely client side with no data model or recording anywhere as it purely serves as an example, if this were to be used in anger it has been quite rightly pointed out that the calculations would need to move to server side or be hosted and called from an external API as proposed by Marcus @pacharenero and Ian.
So the App starts with basic demographics collection:
followed by capture of the time of paracetamol ingestion this is used to plot on a timeline to show the stage of treatment, if past 8 hours the rest of the form reorders so that treatment is commenced before blood tests :
Otherwise the App prompts for bloods next and shows the appropriate bottles:
Blood results can be input next to plot the plasma levels back over time on a chart, there is also a “treatment line” on the chart if the plasma level plots above this then treatment is indicated:
The weight of the Su can be input to calculate the dose, volume and rate of three infusions again this uses visual prompt, thanks to Marcus for suggestions re drip bags changing appropriately and scale for comparison.
Final blood tests are then prompted:
and finally referrals on:
This can be seen at: ParacetamolPathway
This has been submitted as a code4health challenge and we hope to progress this soon.
Yet to be done… their needs to be the addition of guidance for activated charcoal administration, there may need to be a post administration continuation depending on final blood results, and the really difficult bit will be adding functionality to accommodate staggered overdose (across a period of more than one hour).
I hope this proves of interest, any comments, advice or guidance are very gratefully received.