#2 — Don't-miss tooltip (encounters HPI + sick visit, max 5)
- New POST /api/dont-miss returning {points: [{point, why}]} capped at 5
(cap defended both in the prompt and server-side .slice(0,5))
- New dontMissTooltip prompt in prompts.js
- New suggestDontMiss() helper in app.js mirroring suggestBillingCodes;
inserts an orange-bordered card next to the note output, silent on empty
- Wired into liveEncounter.js (encounter HPI) and sickVisit.js. Not added
to wellvisit/soap/hospital/chart per spec.
#1 — Bedside suture selector
- New ES module public/js/bedside/sutures.js (~300L) following the
burns.js pattern: site × age × tension × cosmetic × contamination ×
hours-since-injury → material, size, technique, removal day range,
glue/Steri-strip alternative, warnings, tetanus reminder.
- 15 anatomic sites covered (face, eyelid, lip vermilion, intraoral,
ear, scalp, neck, trunk, upper/lower ext, hand, foot, joint surface,
genitalia, fingertip).
- Bites: cat/human → don't-close-primarily warning; dog bite to hand →
loose-approximation note. Heavy contamination → delayed primary
closure. >12h non-face/scalp → judgment call note.
- Removal days shown as ranges (3–5, 7–10, 10–14) per source norms,
not single midpoints.
- Subungual hematoma trephination guidance corrected: any painful
hematoma with intact nail and no displaced fracture (especially if
25–50% or more), per current UpToDate guidance.
- Inline citation: Roberts & Hedges 7e (2019), Fleisher & Ludwig 8e,
AAP Section on EM, UpToDate (Pope JV).
- Pill registered in sub-nav SECTIONS + bedside/index.js. Persists
active state via existing UIState helper.
All 46 tests pass.
Tab-level choice (ped_last_tab) already survived sign-out/in via
localStorage, but sub-pill and sub-tab selections inside a loaded tab
lived only in memory — they reset to defaults after a reload or
browser restart. Now the following are persisted under the ped_ui/
namespace:
- Calculators nav pill (BP / BMI / GCS / …)
- Bedside sub-pill (neonatal / airway / …)
- Well Visit sub-tab (byvisit / milestones / shadess / note)
- Physical Exam Guide age group + system
Implementation:
- Added public/js/ui-state.js — a ~30-line window.UIState wrapper
around localStorage with a ped_ui/ prefix and try/catch around both
read and write (Safari private mode + quota errors silently no-op).
- Each tab's click handler now also calls UIState.set; each tab's
init path calls UIState.get and replays the saved value through
the same function a click would call — so there is exactly one
code path for "show this selection", whether it came from the user
or from a restore. For Bedside, the restore additionally listens
for tabChanged so the lazy-loaded HTML is guaranteed to exist by
the time we re-activate the pill.
Tests:
- e2e/tests/ui-state-persistence.spec.js — 5 specs × 2 viewports =
10 tests. Each clicks the feature, reloads the page, and asserts
the same pill / subtab / dropdown value is still active. Catches
any future regression in the persistence wiring.
- e2e/tests/soap-hospital-workflow.spec.js — fills SOAP transcript,
generates via mocked AI, clears, opens/closes load popovers; also
smoke-tests the Hospital Course save-bar.
Suite: 250 passed / 0 failed (+ 20 over the last run).
The previous LMS table (L rounded to 2 decimals, ~0 near term) underfit
the skew of Fenton 2013 and drifted ~0.05 z-score units from peditools
and Epic at term. Worst-case this could push borderline infants across
the SGA/AGA cutoff — 10th percentile ≈ z = -1.28, a 0.05-SD drift is
enough to flip the classification.
New LMS: empirically fit against 6 probe weights per week at
peditools.org/fenton2013 (widely-used Fenton 2013 calculator). Validated
across all 21 weeks × both sexes × 5 weights per case (210 cases) —
every one agrees with peditools within 0.01 z-score units, mean
difference 0.002.
Example — 40 5/7 wk male, 3070 g:
BEFORE: z = -1.38 (matched only one of three external sources)
AFTER: z = -1.42 (matches Epic -1.43 and third-source -1.44)
Peditools at integer 40w: z = -1.10 (exact match with new table at
integer-week input)
LMS fit RMSE < 0.005 z-score units per week; see commit message for the
back-solve methodology.
Split the Bedside clinical reference section out of calculators.js
(~1220 lines) into 20 focused ES modules under public/js/bedside/.
Each module owns one clinical topic (cardiac, seizure, sepsis, burns,
etc.) and exports an init() wired up by bedside/index.js. Shared
helpers live in shared.js and also set window._EM for back-compat
with the 4 remaining call sites in calculators.js.
Load order: classic defer calculators.js first, then module script
bedside/index.js. Handlers bind at DOM-ready; runtime _EM lookups
resolve after both are evaluated.
Makes bedside content editable per-section, shrinks calculators.js
from 4111 to 2891 lines, and keeps the existing Playwright smoke
suite (e2e/tests/bedside-smoke.spec.js) as the behavioral contract.