// ============================================================
// bedside/trauma.js
// TRAUMA — primary survey, MTP, c-spine, shock signs.
// ============================================================
import { S } from './shared.js';
function showTrauma() {
var wt = parseFloat(document.getElementById('trauma-weight').value);
var el = document.getElementById('trauma-result');
var html = '';
html += 'Primary Survey — ABCDE
';
html += S.stepBox('#ef4444', 'A — Airway + c-spine', 'Maintain airway (jaw thrust, suction). Manual inline stabilization; apply collar. Intubate if GCS ≤8, inadequate airway, or impending compromise. Avoid succinylcholine if burn/crush/prolonged immobilization.');
html += S.stepBox('#f59e0b', 'B — Breathing', 'SpO2, bilateral breath sounds, chest wall integrity. Identify tension PTX (needle decompression), open PTX (3-sided dressing), flail chest, massive hemothorax.');
html += S.stepBox('#10b981', 'C — Circulation', 'Two large-bore IVs / IO. Control hemorrhage (direct pressure, tourniquet, pelvic binder). ' + (wt ? 'NS or LR 20 mL/kg = ' + S.d(wt, 20) + ' mL bolus.' : 'NS/LR 20 mL/kg bolus.') + ' Consider blood after 40-60 mL/kg crystalloid or in Class III shock.');
html += S.stepBox('#3b82f6', 'D — Disability', 'GCS, pupils, glucose, gross motor. Consider ↑ICP (head up 30°, mannitol 0.5-1 g/kg or hypertonic saline 3% 3-5 mL/kg).');
html += S.stepBox('#8b5cf6', 'E — Exposure + environment', 'Fully expose; prevent hypothermia (warm blankets, fluids).');
html += 'Massive Transfusion Protocol (MTP)
';
html += S.drugTable(
S.drugRow('Ratio', '1:1:1 (pRBC : FFP : platelets)', '—', 'Activate early if ≥40 mL/kg transfused or ongoing hemorrhage. Avoid excessive crystalloid.') +
S.drugRow('Tranexamic acid (TXA)', '15 mg/kg IV (max 1 g) over 10 min → 2 mg/kg/hr × 8h', 'IV', 'Within 3 hr of injury. CRASH-2 / MATIC.') +
S.drugRow('Calcium', '20 mg/kg CaCl or 60 mg/kg Ca-gluconate IV per unit citrated blood', 'IV', 'Citrated blood chelates calcium.')
);
html += 'C-spine clearance (NEXUS / CCR)
';
html += 'Pediatric c-spine decision tools are imperfect. Imaging if any: focal neurologic deficit, altered mental status, neck pain / tenderness, torticollis, substantial torso injury, high-risk mechanism (diving, MVC >55 mph, fall >10 ft). Plain films + CT if positive or equivocal.
';
html += 'Pediatric shock — signs
';
html += 'Children compensate well — hypotension is a late finding. Early signs: tachycardia, cool extremities, weak peripheral pulses, prolonged cap refill (>3 sec), narrowed pulse pressure, altered mentation. Minimum SBP = 70 + (2 × age in years) for ages 1-10.
';
html += 'Secondary survey — AMPLE + head-to-toe
';
html += 'AMPLE: Allergies, Medications, Past history, Last meal, Events of injury. Head-to-toe exam; log-roll for back; digital rectal; neurovascular checks of all extremities.
';
html += S.ref('ATLS 10th ed; PALS 2020; PECARN c-spine rule; CRASH-2 trial (TXA).');
el.innerHTML = html;
}
export function init() {
document.addEventListener('click', function(e) {
if (e.target.id === 'btn-trauma-show' || e.target.closest('#btn-trauma-show')) showTrauma();
});
}