From 9e47a875a9185e3132b5341bf06e419e03cecd85 Mon Sep 17 00:00:00 2001 From: pavl-g Date: Sun, 5 Apr 2026 15:22:30 +0200 Subject: [PATCH 1/4] playbook: dot extension --- antora-playbook.yml | 2 ++ 1 file changed, 2 insertions(+) diff --git a/antora-playbook.yml b/antora-playbook.yml index 0332b06..aaec529 100644 --- a/antora-playbook.yml +++ b/antora-playbook.yml @@ -19,3 +19,5 @@ asciidoc: page-pagination: '' idprefix: '' stem: latexmath + extensions: + - asciidoctor-kroki \ No newline at end of file From 770d08208a1d96928ce3e01dc0f7adb5707080a0 Mon Sep 17 00:00:00 2001 From: pavl-g Date: Sun, 5 Apr 2026 15:23:07 +0200 Subject: [PATCH 2/4] Clinical-Comp: added xABCDE ATLS --- .../assets/dot/atls_xabcde_algorithm.dot | 869 ++++++++++++++++++ .../COMPANION/assets/images/xabcde/atls.svg | 866 +++++++++++++++++ modules/COMPANION/nav.adoc | 3 +- modules/COMPANION/pages/comp.adoc | 2 +- modules/COMPANION/pages/xabcde.adoc | 19 + 5 files changed, 1757 insertions(+), 2 deletions(-) create mode 100644 modules/COMPANION/assets/dot/atls_xabcde_algorithm.dot create mode 100644 modules/COMPANION/assets/images/xabcde/atls.svg create mode 100644 modules/COMPANION/pages/xabcde.adoc diff --git a/modules/COMPANION/assets/dot/atls_xabcde_algorithm.dot b/modules/COMPANION/assets/dot/atls_xabcde_algorithm.dot new file mode 100644 index 0000000..3f9e34e --- /dev/null +++ b/modules/COMPANION/assets/dot/atls_xabcde_algorithm.dot @@ -0,0 +1,869 @@ +/** + * ATLS 11th Edition — xABCDE Primary Survey Algorithm + * Three-Column Layout: + * LEFT → Sequential algorithm nodes (brief, decision-flow) + * MIDDLE → Detailed breakdown of each maneuver + * RIGHT → Image placeholder template for each step + * + * Render with: + * dot -Tsvg atls_xabcde_algorithm.dot -o atls_xabcde_algorithm.svg + * dot -Tpdf atls_xabcde_algorithm.dot -o atls_xabcde_algorithm.pdf + * + * Editing notes: + * • Each PRIMARY step has a matching DETAIL node (suffix _d) and IMAGE node (suffix _i) + * • Column membership is controlled by invisible rank-constraining edges + * • Colors follow ATLS severity convention: + * Red → Immediate life-threat + * Orange → Urgent maneuver + * Yellow → Assessment / evaluation + * Green → Completed / stable + * Blue → Adjunct / monitoring + * Gray → Image placeholder + */ + +digraph ATLS_xABCDE { + + /* ───────────────────────────────────────────── + GLOBAL GRAPH SETTINGS + ───────────────────────────────────────────── */ + graph [ + rankdir = TB + splines = spline + nodesep = 0.55 + ranksep = 0.70 + fontname = "Helvetica Neue" + fontsize = 11 + pad = 0.5 + bgcolor = "#FAFAFA" + label = "ATLS® 11th Edition | Primary Survey: xABCDE Algorithm\nAmerican College of Surgeons Committee on Trauma" + labelloc = t + labeljust = c + fontsize = 16 + ] + + node [ + fontname = "Helvetica Neue" + fontsize = 10 + style = "filled,rounded" + penwidth = 1.5 + margin = "0.20,0.12" + ] + + edge [ + fontname = "Helvetica Neue" + fontsize = 9 + color = "#444444" + arrowsize = 0.8 + ] + + /* ═══════════════════════════════════════════════════════════════════ + COLUMN HEADER NODES + ═══════════════════════════════════════════════════════════════════ */ + + subgraph cluster_headers { + rank = same + style = invis + + hdr_L [ + label = "SEQUENTIAL ALGORITHM\n(Primary Survey Flow)" + shape = rect + style = "filled" + fillcolor = "#1A1A2E" + fontcolor = white + fontsize = 12 + fontname = "Helvetica Neue Bold" + width = 3.2 + ] + + hdr_M [ + label = "MANEUVER DETAIL\n(Assessment & Intervention)" + shape = rect + style = "filled" + fillcolor = "#16213E" + fontcolor = white + fontsize = 12 + fontname = "Helvetica Neue Bold" + width = 4.5 + ] + + hdr_R [ + label = "ILLUSTRATION TEMPLATE\n(Clinical Image Placeholder)" + shape = rect + style = "filled" + fillcolor = "#0F3460" + fontcolor = white + fontsize = 12 + fontname = "Helvetica Neue Bold" + width = 3.0 + ] + } + + /* ═══════════════════════════════════════════════════════════════════ + STEP 0 — SCENE SAFETY & PREPARATION + ═══════════════════════════════════════════════════════════════════ */ + + /* ── LEFT ── */ + S0 [ + label = "PREPARATION\n& SCENE SAFETY" + shape = octagon + fillcolor = "#2D4A22" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + ] + + /* ── MIDDLE ── */ + S0_d [ + label = < + + +
PREPARATION & PPE
+ • Don PPE: gloves, gown, eye/face protection
+ • Prearrival huddle — assign team roles
+ • Activate trauma team notification
+ • Assess available resources (blood, OR, ICU)
+ • Review mechanism via MIST handover tool
+ • Airway cart, IV access, monitoring ready
+ • Activate MTP/MHP if major hemorrhage likely
+ • Designate team leader and scribe
+
> + shape = plain + margin = 0 + ] + + /* ── RIGHT ── */ + S0_i [ + label = "[ IMAGE PLACEHOLDER ]\n\nTrauma bay setup:\nTeam in PPE surrounding\nbay; equipment layout;\nrole assignment diagram" + shape = rect + style = "dashed,filled" + fillcolor = "#E8EAF6" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + STEP x — EXSANGUINATION (EXTERNAL HEMORRHAGE CONTROL) + ═══════════════════════════════════════════════════════════════════ */ + + Sx [ + label = "x — EXSANGUINATION\nExternal Hemorrhage\nControl" + shape = hexagon + fillcolor = "#B71C1C" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + ] + + Sx_d [ + label = < + + +
x — EXSANGUINATION CONTROL
+ Assess: Visible life-threatening external bleeding
+ ↳ Extremity wounds, scalp, junctional zones
+
+ Interventions (apply immediately):
+ • Direct pressure — first-line for all wounds
+ • Tourniquet (TQ) — proximal extremity; note time
+ • Wound packing with hemostatic gauze (junctional)
+ • Pelvic binder — suspected pelvic ring disruption
+ • Sutures/clips — scalp lacerations
+ • Resuscitative Endovascular Balloon Occlusion
+ of the Aorta (REBOA) — if available, Zone III/I
+
+ Key principle: Control exsanguination BEFORE
+ airway management in actively bleeding patients
+
> + shape = plain + margin = 0 + ] + + Sx_i [ + label = "[ IMAGE PLACEHOLDER ]\n\nTourniquet application\nto proximal thigh;\nwound packing technique;\npelvic binder placement" + shape = rect + style = "dashed,filled" + fillcolor = "#FFEBEE" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + STEP A — AIRWAY WITH C-SPINE PROTECTION + ═══════════════════════════════════════════════════════════════════ */ + + SA [ + label = "A — AIRWAY\n+ C-Spine Protection" + shape = hexagon + fillcolor = "#E65100" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + ] + + SA_dec [ + label = "Airway\nPatent?" + shape = diamond + fillcolor = "#FFE0B2" + fontcolor = "#BF360C" + fontsize = 10 + fontname = "Helvetica Neue Bold" + width = 2.2 + ] + + SA_basic [ + label = "BASIC AIRWAY\nManeuvers" + shape = rect + fillcolor = "#FF8F00" + fontcolor = white + fontsize = 10 + width = 2.5 + ] + + SA_defin [ + label = "DEFINITIVE AIRWAY\nRequired?" + shape = diamond + fillcolor = "#FFE0B2" + fontcolor = "#BF360C" + fontsize = 10 + fontname = "Helvetica Neue Bold" + width = 2.5 + ] + + SA_rsi [ + label = "RSI / Surgical\nAirway" + shape = rect + fillcolor = "#D84315" + fontcolor = white + fontsize = 10 + width = 2.2 + ] + + SA_d [ + label = < + + +
A — AIRWAY MANAGEMENT
+ Assessment:
+ • Talk to patient — if they respond clearly, airway intact
+ • Look: agitation, cyanosis, accessory muscle use
+ • Listen: stridor, gurgling, silence (apnea)
+ • Check: blood, vomit, teeth, foreign body, facial trauma
+ • Thermal/inhalation injury signs
+
+ Basic maneuvers (C-spine in-line):
+ • Chin lift / jaw thrust (avoid head-tilt in trauma)
+ • Suction — clear oropharynx
+ • Oropharyngeal airway (OPA) — unconscious, no gag
+ • Nasopharyngeal airway (NPA) — conscious/semi
+ • Supraglottic device (LMA) — bridge/rescue
+
+ Definitive airway indications:
+ • GCS ≤8 / apnea / airway not maintainable
+ • Anticipated loss (burns, expanding hematoma)
+ • Orotracheal RSI — preferred method
+ • Video laryngoscopy — recommended
+ • Bougie — have immediately available
+ • Surgical airway (cricothyrotomy) — cannot intubate
+
+ C-Spine: Maintain in-line stabilisation throughout
+ Post-intubation: confirm with ETCO2 + CXR
+
> + shape = plain + margin = 0 + ] + + SA_i [ + label = "[ IMAGE PLACEHOLDER ]\n\nJaw thrust with\nin-line C-spine;\nvideo laryngoscopy\nfor RSI; surgical\ncricothyrotomy kit" + shape = rect + style = "dashed,filled" + fillcolor = "#FFF3E0" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + STEP B — BREATHING & VENTILATION + ═══════════════════════════════════════════════════════════════════ */ + + SB [ + label = "B — BREATHING\n& Ventilation" + shape = hexagon + fillcolor = "#1565C0" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + ] + + SB_dec [ + label = "Immediate\nLife-Threat?" + shape = diamond + fillcolor = "#BBDEFB" + fontcolor = "#0D47A1" + fontsize = 10 + fontname = "Helvetica Neue Bold" + width = 2.3 + ] + + SB_tx [ + label = "TREAT IMMEDIATELY\n(Tension / Open / Flail)" + shape = rect + fillcolor = "#0D47A1" + fontcolor = white + fontsize = 10 + width = 2.8 + ] + + SB_d [ + label = < + + +
B — BREATHING ASSESSMENT & MANAGEMENT
+ Assessment (LOOK / LISTEN / FEEL):
+ • Expose chest fully — compare both sides
+ • RR: normal 12–20 /min; tachypnea >20 = concern
+ • SpO2 — target ≥94% (trauma); 88–92% in COPD
+ • Percussion: hyper-resonance (PTX) / dullness (HTX)
+ • Auscultate: equal air entry bilaterally
+ • Tracheal position, JVD, chest wall motion/symmetry
+
+ Immediate life-threats — treat when found:
+ 1. Tension Pneumothorax
+ → Needle decompression 2nd ICS MCL (or 4th ICS AAL)
+ → Finger/tube thoracostomy; CXD tube 4th ICS
+ 2. Open (Sucking) Chest Wound
+ → 3-sided occlusive dressing; later chest drain
+ 3. Massive Haemothorax
+ → Large-bore chest drain 4th/5th ICS; IV access
+ 4. Flail Chest + Pulmonary Contusion
+ → Oxygenation, analgesia, consider NIV/intubation
+
+ Ventilated patients:
+ • Confirm ETCO2 waveform post-intubation
+ • Low ETCO2 = hypovolaemia / displaced ETT
+ • Tidal volume 6–8 mL/kg IBW; avoid barotrauma
+
> + shape = plain + margin = 0 + ] + + SB_i [ + label = "[ IMAGE PLACEHOLDER ]\n\nNeedle decompression\n2nd ICS MCL; chest\ndrain insertion;\n3-sided dressing;\nflail segment" + shape = rect + style = "dashed,filled" + fillcolor = "#E3F2FD" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + STEP C — CIRCULATION & HEMORRHAGE CONTROL + ═══════════════════════════════════════════════════════════════════ */ + + SC [ + label = "C — CIRCULATION\n& Hemorrhage Control" + shape = hexagon + fillcolor = "#880E4F" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + ] + + SC_dec [ + label = "Shock\nPresent?" + shape = diamond + fillcolor = "#FCE4EC" + fontcolor = "#880E4F" + fontsize = 10 + fontname = "Helvetica Neue Bold" + width = 2.0 + ] + + SC_class [ + label = "CLASS\nHaemorrhage" + shape = rect + fillcolor = "#AD1457" + fontcolor = white + fontsize = 10 + width = 2.2 + ] + + SC_src [ + label = "SOURCE\nControl" + shape = rect + fillcolor = "#6A1B4D" + fontcolor = white + fontsize = 10 + width = 2.0 + ] + + SC_d [ + label = < + + +
C — CIRCULATION ASSESSMENT & RESUSCITATION
+ Signs of shock:
+ • HR >100, RR >20, CRT >2s, cool/clammy
+ • SBP <90 = LATE sign; don't wait for hypotension
+ • Altered mentation, decreased pulse pressure
+ • Urinary output <0.5 mL/kg/hr
+
+ Haemorrhage Classification (approximate):
+ Class I : <750 mL (<15%) — minimal signs
+ Class II : 750–1500 mL (15–30%) — tachycardia
+ Class III: 1500–2000 mL (30–40%)— hypotension
+ Class IV : >2000 mL (>40%) — life-threatening
+
+ Source identification ("5 Boxes"):
+ Chest | Abdomen | Pelvis | Long bones | "Floor"
+ → eFAST, Pelvis XR, Long bone XR
+
+ Resuscitation — Damage Control:
+ • 2 large-bore IVs (14–16G) or IO access
+ • Balanced haemostatic resus: pRBC:FFP:PLT = 1:1:1
+ • Whole blood preferred if available
+ • TXA ≤3 hr from injury: 1g IV over 10 min loading
+ • Permissive hypotension: SBP 80–90 mmHg (no TBI)
+ • Activate MTP early; avoid crystalloid excess
+ • Calcium supplementation with massive transfusion
+
+ Source control options:
+ • External: TQ, packing, pelvic binder
+ • OR: damage control laparotomy/thoracotomy
+ • IR: angioembolisation (pelvic, solid organ)
+ • REBOA as bridge to definitive control
+
+ Non-haemorrhagic shock:
+ Tension PTX → decompress | Tamponade → FAST → EDEP
+ Neurogenic → fluids + vasopressors after excluding bleed
+
> + shape = plain + margin = 0 + ] + + SC_i [ + label = "[ IMAGE PLACEHOLDER ]\n\nTwo large-bore IVs;\neFAST probe positions;\npelvic binder;\nblood product ratios\ninfographic" + shape = rect + style = "dashed,filled" + fillcolor = "#FCE4EC" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + STEP D — DISABILITY (NEUROLOGICAL) + ═══════════════════════════════════════════════════════════════════ */ + + SD [ + label = "D — DISABILITY\nNeurological Status" + shape = hexagon + fillcolor = "#4A148C" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + ] + + SD_dec [ + label = "GCS ≤8 or\nLateralising?" + shape = diamond + fillcolor = "#EDE7F6" + fontcolor = "#4A148C" + fontsize = 10 + fontname = "Helvetica Neue Bold" + width = 2.3 + ] + + SD_act [ + label = "Protect Airway\nNeuro Consult" + shape = rect + fillcolor = "#6A1B9A" + fontcolor = white + fontsize = 10 + width = 2.3 + ] + + SD_d [ + label = < + + +
D — DISABILITY: NEUROLOGICAL ASSESSMENT
+ Rapid neuro exam (AVPU → GCS):
+ A — Alert; V — Voice; P — Pain; U — Unresponsive
+
+ Glasgow Coma Scale (GCS) 3–15:
+ Eyes: 4-Spontaneous / 3-Voice / 2-Pain / 1-None
+ Verbal: 5-Oriented / 4-Confused / 3-Words / 2-Sounds / 1-None
+ Motor: 6-Obeys / 5-Localises / 4-Withdraws / 3-Flexion
+ 2-Extension / 1-None
+ Motor GCS <6 = unable to follow commands (field triage)
+
+ Pupil exam:
+ • Size, symmetry, reactivity bilaterally
+ • Unilateral fixed dilated = herniation until proven otherwise
+
+ Lateralising signs:
+ • Asymmetric limb movement / posturing
+ • Indicates structural CNS injury
+
+ Management priorities:
+ • Prevent secondary brain injury (hypoxia + hypotension)
+ • Maintain SpO2 ≥94%, SBP ≥110 mmHg in isolated TBI
+ • GCS ≤8 → definitive airway (if not already secured)
+ • Hyperventilation ONLY for impending herniation (transient)
+ • Blood glucose check — correct hypoglycaemia
+ • Avoid hyperglycaemia
+ • Neurosurgery activation: GCS drop, haematoma on imaging
+
> + shape = plain + margin = 0 + ] + + SD_i [ + label = "[ IMAGE PLACEHOLDER ]\n\nGCS scoring table;\npupil assessment\ndiagram; AVPU\nresponse scale" + shape = rect + style = "dashed,filled" + fillcolor = "#EDE7F6" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + STEP E — EXPOSURE & ENVIRONMENTAL CONTROL + ═══════════════════════════════════════════════════════════════════ */ + + SE [ + label = "E — EXPOSURE\n& Environment" + shape = hexagon + fillcolor = "#1B5E20" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + ] + + SE_d [ + label = < + + +
E — EXPOSURE & ENVIRONMENT
+ Exposure:
+ • Remove all clothing (cut if necessary)
+ • Log-roll with C-spine control → inspect back
+ • Perineum, axillae, gluteal folds examined
+ • "The Floor" — check beneath patient for hidden bleeding
+ • Remove penetrating objects only in controlled setting
+
+ Environmental control (prevent hypothermia):
+ • Core temp target: >35°C (lethal triad: coagulopathy
+ + acidosis + hypothermia)
+ • Warm blankets immediately after exam
+ • Warmed IV fluids and blood products
+ • Convection warming devices (Bair Hugger)
+ • Warm ambient room temperature
+ • Active rewarming for T <32°C
+
+ Log-roll technique:
+ • Minimum 3 people + leader controlling head/C-spine
+ • Spine board removed once safe to do so
+
> + shape = plain + margin = 0 + ] + + SE_i [ + label = "[ IMAGE PLACEHOLDER ]\n\nLog-roll technique\nwith C-spine control;\nwarming blanket\napplication; back\ninspection" + shape = rect + style = "dashed,filled" + fillcolor = "#E8F5E9" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + ADJUNCTS TO PRIMARY SURVEY + ═══════════════════════════════════════════════════════════════════ */ + + ADJ [ + label = "ADJUNCTS TO\nPRIMARY SURVEY" + shape = rect + fillcolor = "#01579B" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + style = "filled,rounded" + ] + + ADJ_d [ + label = < + + +
ADJUNCTS TO PRIMARY SURVEY
+ Monitoring (continuous):
+ • ECG — arrhythmia, blunt cardiac injury
+ • Pulse oximetry (SpO2)
+ • Capnography (ETCO2) — post-intubation
+ • Blood pressure (arterial line preferred in instability)
+ • Temperature
+ • Urinary catheter — UO 0.5 mL/kg/hr target
+ • Gastric decompression — NG or OG tube
+
+ Imaging:
+ • CXR — haemo/pneumothorax, mediastinum, lines
+ • Pelvis XR — pelvic ring disruption
+ • eFAST — pericardial, peritoneal, pleural fluid
+ • CECT whole body ("pan-scan") when stabilised
+
+ Lab:
+ • ABG — pH, lactate, base deficit, PaO2
+ • FBC, coagulation (PT, APTT, fibrinogen), TEG/ROTEM
+ • Type & crossmatch / group & screen
+ • β-hCG (all reproductive-age females)
+ • BMP, troponin, toxicology screen
+
> + shape = plain + margin = 0 + ] + + ADJ_i [ + label = "[ IMAGE PLACEHOLDER ]\n\neFAST probe positions\n(pericardial, hepato-\nrenal, spleno-renal,\npelvic, pleural);\nCXR example" + shape = rect + style = "dashed,filled" + fillcolor = "#E1F5FE" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + REEVALUATION LOOP + ═══════════════════════════════════════════════════════════════════ */ + + REEVAL [ + label = "REEVALUATE\nRepeat xABCDE" + shape = ellipse + fillcolor = "#F57F17" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 2.8 + style = "filled" + ] + + REEVAL_d [ + label = < + + +
REEVALUATION — CRITICAL STEP
+ Reevaluate continuously throughout primary survey
+
+ • Repeat full xABCDE when clinical status changes
+ • Deterioration may indicate new/missed injury
+ • Serial GCS, vital signs, lactate clearance
+ • Reassess response to resuscitation
+ • Update team with huddle/time-out
+ • If condition worsens → return to "x" (haemorrhage)
+
+ Specific reevaluation triggers:
+ • Failure to respond to fluid resuscitation
+ • Sudden haemodynamic deterioration
+ • Worsening GCS or new pupil changes
+ • Increasing ventilatory requirements
+ • Rising airway pressures in ventilated patient
+
> + shape = plain + margin = 0 + ] + + REEVAL_i [ + label = "[ IMAGE PLACEHOLDER ]\n\nTeam huddle around\npatient; vital signs\ntrend graph; serial\nassessment checklist" + shape = rect + style = "dashed,filled" + fillcolor = "#FFF8E1" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + SECONDARY SURVEY / TRANSFER DECISION + ═══════════════════════════════════════════════════════════════════ */ + + SS [ + label = "SECONDARY SURVEY\nHead-to-Toe +\nFull History" + shape = rect + fillcolor = "#37474F" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + style = "filled,rounded" + ] + + SS_d [ + label = < + + +
SECONDARY SURVEY
+ Initiate ONLY after primary survey stabilisation
+
+ History — SAMPLE:
+ S — Symptoms / Signs
+ A — Allergies
+ M — Medications (anticoagulants, steroids)
+ P — Past medical/surgical history
+ L — Last meal (aspiration risk)
+ E — Events leading to injury / mechanism
+
+ Head-to-toe physical exam:
+ Head → Face → Neck → Chest → Abdomen
+ → Pelvis → Perineum → Extremities → Back
+
+ Transfer decision:
+ • Consider if injuries exceed institutional capability
+ • Use S-xABCDE-BAR handover tool for communication
+ • Arrange definitive care (OR / ICU / neurosurgery)
+
> + shape = plain + margin = 0 + ] + + SS_i [ + label = "[ IMAGE PLACEHOLDER ]\n\nSystematic head-to-toe\nexam sequence diagram;\nSAMPLE history card;\nS-xABCDE-BAR\ntransfer tool" + shape = rect + style = "dashed,filled" + fillcolor = "#ECEFF1" + fontcolor = "#37474F" + fontsize = 9 + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + DEFINITIVE CARE (TERMINAL NODE) + ═══════════════════════════════════════════════════════════════════ */ + + DEFCARE [ + label = "DEFINITIVE CARE\nOR / ICU / Transfer" + shape = octagon + fillcolor = "#2D4A22" + fontcolor = white + fontsize = 11 + fontname = "Helvetica Neue Bold" + width = 3.0 + ] + + /* ═══════════════════════════════════════════════════════════════════ + RANK ALIGNMENT — INVISIBLE SPACER EDGES TO ENFORCE COLUMNS + Each "rank" block forces left/middle/right on same horizontal band + ═══════════════════════════════════════════════════════════════════ */ + + /* invisible linking node for column alignment */ + node [shape=point width=0 height=0 style=invis label=""] + r0L; r0M; r0R + r1L; r1M; r1R + r2L; r2M; r2R + r3L; r3M; r3R + r4L; r4M; r4R + r5L; r5M; r5R + r6L; r6M; r6R + r7L; r7M; r7R + r8L; r8M; r8R + + /* same-rank groupings */ + { rank=same; hdr_L; hdr_M; hdr_R } + { rank=same; S0; S0_d; S0_i } + { rank=same; Sx; Sx_d; Sx_i } + { rank=same; SA; SA_d; SA_i } + { rank=same; SB; SB_d; SB_i } + { rank=same; SC; SC_d; SC_i } + { rank=same; SD; SD_d; SD_i } + { rank=same; SE; SE_d; SE_i } + { rank=same; ADJ; ADJ_d; ADJ_i } + { rank=same; REEVAL; REEVAL_d; REEVAL_i } + { rank=same; SS; SS_d; SS_i } + { rank=same; DEFCARE } + + /* ═══════════════════════════════════════════════════════════════════ + LEFT COLUMN — MAIN ALGORITHM FLOW EDGES + ═══════════════════════════════════════════════════════════════════ */ + + hdr_L -> S0 [ style=invis ] + S0 -> Sx [ label=" Life-threatening\n bleed?" color="#B71C1C" fontcolor="#B71C1C" penwidth=2 ] + Sx -> SA [ label=" Controlled" color="#2E7D32" penwidth=2 ] + SA -> SA_dec [ color="#E65100" penwidth=1.5 ] + SA_dec -> SA_basic [ label="No" color="#E65100" ] + SA_dec -> SA_defin [ label="Yes → Open" color="#2E7D32" ] + SA_basic -> SA_defin [ color="#888888" ] + SA_defin -> SA_rsi [ label="Yes" color="#D84315" ] + SA_defin -> SB [ label="No → ETT\nconfirmed" color="#2E7D32" ] + SA_rsi -> SB [ color="#2E7D32" ] + SB -> SB_dec [ color="#1565C0" penwidth=1.5 ] + SB_dec -> SB_tx [ label="Yes" color="#D32F2F" ] + SB_dec -> SC [ label="No" color="#2E7D32" ] + SB_tx -> SC [ color="#2E7D32" ] + SC -> SC_dec [ color="#880E4F" penwidth=1.5 ] + SC_dec -> SC_class [ label="Yes" color="#AD1457" ] + SC_class -> SC_src [ color="#6A1B4D" ] + SC_src -> SD [ color="#2E7D32" ] + SC_dec -> SD [ label="No" color="#2E7D32" ] + SD -> SD_dec [ color="#4A148C" penwidth=1.5 ] + SD_dec -> SD_act [ label="Yes" color="#6A1B9A" ] + SD_dec -> SE [ label="No" color="#2E7D32" ] + SD_act -> SE [ color="#2E7D32" ] + SE -> ADJ [ color="#01579B" penwidth=1.5 ] + ADJ -> REEVAL [ color="#F57F17" penwidth=2 ] + REEVAL -> SS [ label=" Vitals\nstabilising" color="#37474F" penwidth=2 ] + REEVAL -> Sx [ label=" Deterioration\n→ restart" color="#B71C1C" style=dashed penwidth=1.5 constraint=false ] + SS -> DEFCARE [ color="#2D4A22" penwidth=2 ] + + /* ═══════════════════════════════════════════════════════════════════ + HORIZONTAL CONNECTORS (LEFT → MIDDLE → RIGHT, invisible weight-0) + These create the 3-column visual without disrupting vertical flow + ═══════════════════════════════════════════════════════════════════ */ + + hdr_L -> hdr_M [ style=invis weight=10 ] + hdr_M -> hdr_R [ style=invis weight=10 ] + + S0 -> S0_d [ style=invis weight=10 ] + S0_d -> S0_i [ style=invis weight=10 ] + + Sx -> Sx_d [ style=invis weight=10 ] + Sx_d -> Sx_i [ style=invis weight=10 ] + + SA -> SA_d [ style=invis weight=10 ] + SA_d -> SA_i [ style=invis weight=10 ] + + SB -> SB_d [ style=invis weight=10 ] + SB_d -> SB_i [ style=invis weight=10 ] + + SC -> SC_d [ style=invis weight=10 ] + SC_d -> SC_i [ style=invis weight=10 ] + + SD -> SD_d [ style=invis weight=10 ] + SD_d -> SD_i [ style=invis weight=10 ] + + SE -> SE_d [ style=invis weight=10 ] + SE_d -> SE_i [ style=invis weight=10 ] + + ADJ -> ADJ_d [ style=invis weight=10 ] + ADJ_d -> ADJ_i [ style=invis weight=10 ] + + REEVAL -> REEVAL_d [ style=invis weight=10 ] + REEVAL_d -> REEVAL_i [ style=invis weight=10 ] + + SS -> SS_d [ style=invis weight=10 ] + SS_d -> SS_i [ style=invis weight=10 ] + +} /* end digraph */ diff --git a/modules/COMPANION/assets/images/xabcde/atls.svg b/modules/COMPANION/assets/images/xabcde/atls.svg new file mode 100644 index 0000000..eebf971 --- /dev/null +++ b/modules/COMPANION/assets/images/xabcde/atls.svg @@ -0,0 +1,866 @@ + + + + + + +ATLS_xABCDE + +ATLS® 11th Edition | Primary Survey: xABCDE Algorithm +American College of Surgeons Committee on Trauma + + +hdr_L + +SEQUENTIAL ALGORITHM +(Primary Survey Flow) + + + +hdr_M + +MANEUVER DETAIL +(Assessment & Intervention) + + + + +S0 + +PREPARATION +& SCENE SAFETY + + + + +hdr_R + +ILLUSTRATION TEMPLATE +(Clinical Image Placeholder) + + + + +S0_d + + + +PREPARATION & PPE + +            • Don PPE: gloves, gown, eye/face protection +            • Prearrival huddle — assign team roles +            • Activate trauma team notification +            • Assess available resources (blood, OR, ICU) +            • Review mechanism via MIST handover tool +            • Airway cart, IV access, monitoring ready +            • Activate MTP/MHP if major hemorrhage likely +            • Designate team leader and scribe +           + + + + +Sx + +x — EXSANGUINATION +External Hemorrhage +Control + + + +S0->Sx + + + Life-threatening + bleed? + + + +S0_i + +[ IMAGE PLACEHOLDER ] +Trauma bay setup: +Team in PPE surrounding +bay; equipment layout; +role assignment diagram + + + + +Sx_d + + + +x — EXSANGUINATION CONTROL + +             +Assess: + Visible life-threatening external bleeding +            ↳ Extremity wounds, scalp, junctional zones +             +             +Interventions (apply immediately): +            • Direct pressure — first-line for all wounds +            • Tourniquet (TQ) — proximal extremity; note time +            • Wound packing with hemostatic gauze (junctional) +            • Pelvic binder — suspected pelvic ring disruption +            • Sutures/clips — scalp lacerations +            • Resuscitative Endovascular Balloon Occlusion +              of the Aorta (REBOA) — if available, Zone III/I +             +             +Key principle: + Control exsanguination BEFORE +            airway management in actively bleeding patients +           + + + + +SA + +A — AIRWAY ++ C-Spine Protection + + + +Sx->SA + + + Controlled + + + +Sx_i + +[ IMAGE PLACEHOLDER ] +Tourniquet application +to proximal thigh; +wound packing technique; +pelvic binder placement + + + + +SA_dec + +Airway +Patent? + + + +SA->SA_dec + + + + + +SA_d + + + +A — AIRWAY MANAGEMENT + +             +Assessment: +            • Talk to patient — if they respond clearly, airway intact +            • Look: agitation, cyanosis, accessory muscle use +            • Listen: stridor, gurgling, silence (apnea) +            • Check: blood, vomit, teeth, foreign body, facial trauma +            • Thermal/inhalation injury signs +             +             +Basic maneuvers (C-spine in-line): +            • Chin lift / jaw thrust (avoid head-tilt in trauma) +            • Suction — clear oropharynx +            • Oropharyngeal airway (OPA) — unconscious, no gag +            • Nasopharyngeal airway (NPA) — conscious/semi +            • Supraglottic device (LMA) — bridge/rescue +             +             +Definitive airway indications: +            • GCS ≤8 / apnea / airway not maintainable +            • Anticipated loss (burns, expanding hematoma) +            • Orotracheal RSI — preferred method +            • Video laryngoscopy — recommended +            • Bougie — have immediately available +            • Surgical airway (cricothyrotomy) — cannot intubate +             +             +C-Spine: + Maintain in-line stabilisation throughout +            Post-intubation: confirm with ETCO2 + CXR +           + + + + +SA_basic + +BASIC AIRWAY +Maneuvers + + + +SA_dec->SA_basic + + +No + + + +SA_defin + +DEFINITIVE AIRWAY +Required? + + + +SA_dec->SA_defin + + +Yes → Open + + + +SA_basic->SA_defin + + + + + +SA_rsi + +RSI / Surgical +Airway + + + +SA_defin->SA_rsi + + +Yes + + + +SB + +B — BREATHING +& Ventilation + + + +SA_defin->SB + + +No → ETT +confirmed + + + +SA_rsi->SB + + + + + +SA_i + +[ IMAGE PLACEHOLDER ] +Jaw thrust with +in-line C-spine; +video laryngoscopy +for RSI; surgical +cricothyrotomy kit + + + + +SB_dec + +Immediate +Life-Threat? + + + +SB->SB_dec + + + + + +SB_d + + + +B — BREATHING ASSESSMENT & MANAGEMENT + +             +Assessment (LOOK / LISTEN / FEEL): +            • Expose chest fully — compare both sides +            • RR: normal 12–20 /min; tachypnea >20 = concern +            • SpO2 — target ≥94% (trauma); 88–92% in COPD +            • Percussion: hyper-resonance (PTX) / dullness (HTX) +            • Auscultate: equal air entry bilaterally +            • Tracheal position, JVD, chest wall motion/symmetry +             +             +Immediate life-threats — treat when found: +            1. Tension Pneumothorax +               → Needle decompression 2nd ICS MCL (or 4th ICS AAL) +               → Finger/tube thoracostomy; CXD tube 4th ICS +            2. Open (Sucking) Chest Wound +               → 3-sided occlusive dressing; later chest drain +            3. Massive Haemothorax +               → Large-bore chest drain 4th/5th ICS; IV access +            4. Flail Chest + Pulmonary Contusion +               → Oxygenation, analgesia, consider NIV/intubation +             +             +Ventilated patients: +            • Confirm ETCO2 waveform post-intubation +            • Low ETCO2 = hypovolaemia / displaced ETT +            • Tidal volume 6–8 mL/kg IBW; avoid barotrauma +           + + + + +SB_tx + +TREAT IMMEDIATELY +(Tension / Open / Flail) + + + +SB_dec->SB_tx + + +Yes + + + +SC + +C — CIRCULATION +& Hemorrhage Control + + + +SB_dec->SC + + +No + + + +SB_tx->SC + + + + + +SB_i + +[ IMAGE PLACEHOLDER ] +Needle decompression +2nd ICS MCL; chest +drain insertion; +3-sided dressing; +flail segment + + + + +SC_dec + +Shock +Present? + + + +SC->SC_dec + + + + + +SC_d + + + +C — CIRCULATION ASSESSMENT & RESUSCITATION + +             +Signs of shock: +            • HR >100, RR >20, CRT >2s, cool/clammy +            • SBP <90 = LATE sign; don't wait for hypotension +            • Altered mentation, decreased pulse pressure +            • Urinary output <0.5 mL/kg/hr +             +             +Haemorrhage Classification (approximate): +            Class I  : <750 mL (<15%)   — minimal signs +            Class II : 750–1500 mL (15–30%) — tachycardia +            Class III: 1500–2000 mL (30–40%)— hypotension +            Class IV : >2000 mL (>40%)  — life-threatening +             +             +Source identification ("5 Boxes"): +            Chest | Abdomen | Pelvis | Long bones | "Floor" +            → eFAST, Pelvis XR, Long bone XR +             +             +Resuscitation — Damage Control: +            • 2 large-bore IVs (14–16G) or IO access +            • Balanced haemostatic resus: pRBC:FFP:PLT = 1:1:1 +            • Whole blood preferred if available +            • TXA ≤3 hr from injury: 1g IV over 10 min loading +            • Permissive hypotension: SBP 80–90 mmHg (no TBI) +            • Activate MTP early; avoid crystalloid excess +            • Calcium supplementation with massive transfusion +             +             +Source control options: +            • External: TQ, packing, pelvic binder +            • OR: damage control laparotomy/thoracotomy +            • IR: angioembolisation (pelvic, solid organ) +            • REBOA as bridge to definitive control +             +             +Non-haemorrhagic shock: +            Tension PTX → decompress | Tamponade → FAST → EDEP +            Neurogenic → fluids + vasopressors after excluding bleed +           + + + + +SC_class + +CLASS +Haemorrhage + + + +SC_dec->SC_class + + +Yes + + + +SD + +D — DISABILITY +Neurological Status + + + +SC_dec->SD + + +No + + + +SC_src + +SOURCE +Control + + + +SC_class->SC_src + + + + + +SC_src->SD + + + + + +SC_i + +[ IMAGE PLACEHOLDER ] +Two large-bore IVs; +eFAST probe positions; +pelvic binder; +blood product ratios +infographic + + + + +SD_dec + +GCS ≤8 or +Lateralising? + + + +SD->SD_dec + + + + + +SD_d + + + +D — DISABILITY: NEUROLOGICAL ASSESSMENT + +             +Rapid neuro exam (AVPU → GCS): +            A — Alert; V — Voice; P — Pain; U — Unresponsive +             +             +Glasgow Coma Scale (GCS) 3–15: +            Eyes:   4-Spontaneous / 3-Voice / 2-Pain / 1-None +            Verbal: 5-Oriented / 4-Confused / 3-Words / 2-Sounds / 1-None +            Motor:  6-Obeys / 5-Localises / 4-Withdraws / 3-Flexion +                    2-Extension / 1-None +            Motor GCS <6 = unable to follow commands (field triage) +             +             +Pupil exam: +            • Size, symmetry, reactivity bilaterally +            • Unilateral fixed dilated = herniation until proven otherwise +             +             +Lateralising signs: +            • Asymmetric limb movement / posturing +            • Indicates structural CNS injury +             +             +Management priorities: +            • Prevent secondary brain injury (hypoxia + hypotension) +            • Maintain SpO2 ≥94%, SBP ≥110 mmHg in isolated TBI +            • GCS ≤8 → definitive airway (if not already secured) +            • Hyperventilation ONLY for impending herniation (transient) +            • Blood glucose check — correct hypoglycaemia +            • Avoid hyperglycaemia +            • Neurosurgery activation: GCS drop, haematoma on imaging +           + + + + +SD_act + +Protect Airway +Neuro Consult + + + +SD_dec->SD_act + + +Yes + + + +SE + +E — EXPOSURE +& Environment + + + +SD_dec->SE + + +No + + + +SD_act->SE + + + + + +SD_i + +[ IMAGE PLACEHOLDER ] +GCS scoring table; +pupil assessment +diagram; AVPU +response scale + + + + +SE_d + + + +E — EXPOSURE & ENVIRONMENT + +             +Exposure: +            • Remove all clothing (cut if necessary) +            • Log-roll with C-spine control → inspect back +            • Perineum, axillae, gluteal folds examined +            • "The Floor" — check beneath patient for hidden bleeding +            • Remove penetrating objects only in controlled setting +             +             +Environmental control (prevent hypothermia): +            • Core temp target: >35°C (lethal triad: coagulopathy +              + acidosis + hypothermia) +            • Warm blankets immediately after exam +            • Warmed IV fluids and blood products +            • Convection warming devices (Bair Hugger) +            • Warm ambient room temperature +            • Active rewarming for T <32°C +             +             +Log-roll technique: +            • Minimum 3 people + leader controlling head/C-spine +            • Spine board removed once safe to do so +           + + + + +ADJ + +ADJUNCTS TO +PRIMARY SURVEY + + + +SE->ADJ + + + + + +SE_i + +[ IMAGE PLACEHOLDER ] +Log-roll technique +with C-spine control; +warming blanket +application; back +inspection + + + + +ADJ_d + + + +ADJUNCTS TO PRIMARY SURVEY + +             +Monitoring (continuous): +            • ECG — arrhythmia, blunt cardiac injury +            • Pulse oximetry (SpO2) +            • Capnography (ETCO2) — post-intubation +            • Blood pressure (arterial line preferred in instability) +            • Temperature +            • Urinary catheter — UO 0.5 mL/kg/hr target +            • Gastric decompression — NG or OG tube +             +             +Imaging: +            • CXR — haemo/pneumothorax, mediastinum, lines +            • Pelvis XR — pelvic ring disruption +            • eFAST — pericardial, peritoneal, pleural fluid +            • CECT whole body ("pan-scan") when stabilised +             +             +Lab: +            • ABG — pH, lactate, base deficit, PaO2 +            • FBC, coagulation (PT, APTT, fibrinogen), TEG/ROTEM +            • Type & crossmatch / group & screen +            • β-hCG (all reproductive-age females) +            • BMP, troponin, toxicology screen +           + + + + +REEVAL + +REEVALUATE +Repeat xABCDE + + + +ADJ->REEVAL + + + + + +ADJ_i + +[ IMAGE PLACEHOLDER ] +eFAST probe positions +(pericardial, hepato- +renal, spleno-renal, +pelvic, pleural); +CXR example + + + + +REEVAL->Sx + + + Deterioration +→ restart + + + +REEVAL_d + + + +REEVALUATION — CRITICAL STEP + +             +Reevaluate continuously throughout primary survey +             +            • Repeat full xABCDE when clinical status changes +            • Deterioration may indicate new/missed injury +            • Serial GCS, vital signs, lactate clearance +            • Reassess response to resuscitation +            • Update team with huddle/time-out +            • If condition worsens → return to "x" (haemorrhage) +             +             +Specific reevaluation triggers: +            • Failure to respond to fluid resuscitation +            • Sudden haemodynamic deterioration +            • Worsening GCS or new pupil changes +            • Increasing ventilatory requirements +            • Rising airway pressures in ventilated patient +           + + + + +SS + +SECONDARY SURVEY +Head-to-Toe + +Full History + + + +REEVAL->SS + + + Vitals +stabilising + + + +REEVAL_i + +[ IMAGE PLACEHOLDER ] +Team huddle around +patient; vital signs +trend graph; serial +assessment checklist + + + + +SS_d + + + +SECONDARY SURVEY + +             +Initiate ONLY after primary survey stabilisation +             +             +History — SAMPLE: +            S — Symptoms / Signs +            A — Allergies +            M — Medications (anticoagulants, steroids) +            P — Past medical/surgical history +            L — Last meal (aspiration risk) +            E — Events leading to injury / mechanism +             +             +Head-to-toe physical exam: +            Head → Face → Neck → Chest → Abdomen +            → Pelvis → Perineum → Extremities → Back +             +             +Transfer decision: +            • Consider if injuries exceed institutional capability +            • Use S-xABCDE-BAR handover tool for communication +            • Arrange definitive care (OR / ICU / neurosurgery) +           + + + + +DEFCARE + +DEFINITIVE CARE +OR / ICU / Transfer + + + +SS->DEFCARE + + + + + +SS_i + +[ IMAGE PLACEHOLDER ] +Systematic head-to-toe +exam sequence diagram; +SAMPLE history card; +S-xABCDE-BAR +transfer tool + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + + diff --git a/modules/COMPANION/nav.adoc b/modules/COMPANION/nav.adoc index 45c28bb..3148c27 100644 --- a/modules/COMPANION/nav.adoc +++ b/modules/COMPANION/nav.adoc @@ -1,2 +1,3 @@ * Clinical Companion -** xref:comp.adoc[The Clinical Companion Cheat Sheet] \ No newline at end of file +** xref:comp.adoc[The Clinical Companion Cheat Sheet] +** xref:xabcde.adoc[ACP xABCDE Approach to traumatic injury] \ No newline at end of file diff --git a/modules/COMPANION/pages/comp.adoc b/modules/COMPANION/pages/comp.adoc index 6676360..82635d5 100644 --- a/modules/COMPANION/pages/comp.adoc +++ b/modules/COMPANION/pages/comp.adoc @@ -2,7 +2,7 @@ [.subtitle] **** -The complete tool to ace the clinical ward service by by link:https://github.com/pavly-gerges[Pavly G.]. +The complete tool to ace the clinical ward service by by link:https://github.com/pavly-gerges[Pavly G.] **** :doctype: article diff --git a/modules/COMPANION/pages/xabcde.adoc b/modules/COMPANION/pages/xabcde.adoc new file mode 100644 index 0000000..df7c3f0 --- /dev/null +++ b/modules/COMPANION/pages/xabcde.adoc @@ -0,0 +1,19 @@ += xABCDE + +[.subtitle] +**** +An approach to traumatic patients based on the ACP Guidelines of ATLS. +**** + +The following graph-based algorithm is built from the **ACP 11^th edition xABCDE ATLS Guidelines**; the algorithm is composed of 3 columnar components; the first column represents a brief about the stage of the resuscitation; the second column demonstrates the detailed steps in a particular phase, and the third column displays illustrating of the maneuvers involved in the current phase <>. + +The **ACC/AHA ACLS Guidelines** could be further interleaved and taken out from the Airway, breathing and circulation components. + + +++++ + + xABCDE Algorithm + +++++ +[.subtite] +[[Fig-1.1]] The ATLS Algorithm based on the ACP 11^th^ edition. \ No newline at end of file From e4421986a4126af5a3bbc9878cb6d29f8c1fbfbd Mon Sep 17 00:00:00 2001 From: pavl-g Date: Sun, 5 Apr 2026 15:24:02 +0200 Subject: [PATCH 3/4] ui: added GLightbox for images --- modules/CASES/pages/dai.adoc | 52 +++++++++++++++++++++++++++++++----- ui-bundle/css/site.css | 8 ++++++ ui-bundle/partials/body.hbs | 12 +++++++++ ui-bundle/partials/head.hbs | 2 ++ 4 files changed, 67 insertions(+), 7 deletions(-) diff --git a/modules/CASES/pages/dai.adoc b/modules/CASES/pages/dai.adoc index 8863ba6..9f60fd0 100644 --- a/modules/CASES/pages/dai.adoc +++ b/modules/CASES/pages/dai.adoc @@ -52,7 +52,12 @@ Full routine laboratory studies was carried-out after the critical care admissio | CT Timeline | Image | Findings a| Day of accident -a| image:tbi-0/dai-ct-1.png[CT,width="",height=""] +a| +++++ + + CT Scan + +++++ a| * Brain Meninges: increased signal intensity along the falx cereberi and the @@ -79,7 +84,12 @@ cerebri and tentorium cerebelli likely subarachinoid bleeders. a| Day of admission (second day after injury) -a| image:tbi-0/dai-ct-2.png[CT,width="",height=""] +a| +++++ + + CT Scan + +++++ a| * Calvaria: right side frontoparietal swelling likely subgaleal hematoma. @@ -113,7 +123,19 @@ a| a| Unremarkable findings. a| Last day from admission day -a| image:tbi-0/dai-us-1.png[US-1,width="",height=""] image:tbi-0/dai-us-2.png[US-2,width="",height=""] +a| +++++ + + USS + +++++ + +++++ + + USS-2 + +++++ + a| * Impression: ** Hepatic focal lesion at the hepatic @@ -383,19 +405,35 @@ Liver and renal function tests and the total creatine kinase levels are highly s == Thumbnails: -image:tbi-0/gcs-score-table.png[gcs-1,width="",height=""] +++++ + + GCS Score + +++++ [.subtitle] [[Fig-1.1]] Fig-1.1 - Prognosis Reclaiming from the GCS-P Score (GCS-PA Charts), a simple graphical tool in the 3-dimensional vector-space. -image:tbi-0/gcs-score-table-2.png[gcs-2,width="",height=""] +++++ + + GCS Score + +++++ [.subtitle] [[Fig-1.2]] Fig-1.2 - GCS-PA combined with brain CT findings. -image:tbi-0/red-nucleus.png[red,width="",height=""] +++++ + + Red Nucleus Pathway + +++++ [.subtitle] [[Fig-2]] Fig-2 - The red nucleus cortical, spinal and cerebellar connections. -image:tbi-0/oculo-sympathetic-pathway.png[pathway,width="",height=""] +++++ + + Pathway + +++++ [.subtitle] [[Fig-3]] Fig-3 - The oculo-sympathetic pathway. diff --git a/ui-bundle/css/site.css b/ui-bundle/css/site.css index 470b2a1..8debea0 100644 --- a/ui-bundle/css/site.css +++ b/ui-bundle/css/site.css @@ -9,4 +9,12 @@ padding-left: 20px; padding-top: -10px; } +.zoom-img { + transition: transform 0.3s ease, box-shadow 0.3s ease; +} + +.zoom-img:hover { + transform: scale(1.08) translateY(-5px); + box-shadow: 0 10px 25px rgba(0,0,0,0.3); +} /*! Adapted from the GitHub style by Vasily Polovnyov */.hljs-comment,.hljs-quote{color:#998;font-style:italic}.hljs-keyword,.hljs-selector-tag,.hljs-subst{color:#333;font-weight:600}.hljs-literal,.hljs-number,.hljs-tag .hljs-attr,.hljs-template-variable,.hljs-variable{color:teal}.hljs-doctag,.hljs-string{color:#d14}.hljs-section,.hljs-selector-id,.hljs-title{color:#900;font-weight:600}.hljs-subst{font-weight:400}.hljs-class .hljs-title,.hljs-type{color:#458;font-weight:600}.hljs-attribute,.hljs-name,.hljs-tag{color:navy;font-weight:400}.hljs-link,.hljs-regexp{color:#009926}.hljs-bullet,.hljs-symbol{color:#990073}.hljs-built_in,.hljs-builtin-name{color:#0086b3}.hljs-meta{color:#999;font-weight:600}.hljs-deletion{background:#fdd}.hljs-addition{background:#dfd}.hljs-emphasis{font-style:italic}.hljs-strong{font-weight:600}@page{margin:.5in}@media print{.hide-for-print{display:none!important}html{font-size:.9375em}a{color:inherit!important;text-decoration:underline}a.bare,a[href^="#"],a[href^="mailto:"]{text-decoration:none}img,object,svg,tr{page-break-inside:avoid}thead{display:table-header-group}pre{-ms-hyphens:none;hyphens:none;white-space:pre-wrap}body{padding-top:2rem}.navbar{background:none;color:inherit;position:absolute}.navbar *{color:inherit!important}.nav-container,.navbar>:not(.navbar-brand),.toolbar,aside.toc,nav.pagination{display:none}.doc{color:inherit;margin:auto;max-width:none;padding-bottom:2rem}.doc .admonitionblock td.icon{-webkit-print-color-adjust:exact;color-adjust:exact}.doc .listingblock code[data-lang]::before{display:block}footer.footer{background:none;border-top:1px solid #e1e1e1;color:#8e8e8e;padding:.25rem .5rem 0}.footer *{color:inherit}} diff --git a/ui-bundle/partials/body.hbs b/ui-bundle/partials/body.hbs index 4a0ac25..982e75a 100644 --- a/ui-bundle/partials/body.hbs +++ b/ui-bundle/partials/body.hbs @@ -1,4 +1,16 @@
{{> nav}} {{> main}} + +
diff --git a/ui-bundle/partials/head.hbs b/ui-bundle/partials/head.hbs index 49d5be2..3f58b69 100644 --- a/ui-bundle/partials/head.hbs +++ b/ui-bundle/partials/head.hbs @@ -8,3 +8,5 @@ + + From 9993d2ecbb908a1dcc56b8544e1104b48c3dfa80 Mon Sep 17 00:00:00 2001 From: pavl-g Date: Sun, 5 Apr 2026 15:24:27 +0200 Subject: [PATCH 4/4] scripts: added dot renderer --- scripts/build.sh | 5 +++++ scripts/install.sh | 2 ++ 2 files changed, 7 insertions(+) diff --git a/scripts/build.sh b/scripts/build.sh index cac89e5..056698d 100644 --- a/scripts/build.sh +++ b/scripts/build.sh @@ -1,3 +1,8 @@ #!/bin/sh +cached_work_dir=$(pwd) +cd ./modules/COMPANION/assets +dot -Tsvg ./dot/atls_xabcde_algorithm.dot -o ./images/xabcde/atls.svg +cd $cached_work_dir + npx antora antora-playbook.yml diff --git a/scripts/install.sh b/scripts/install.sh index b011619..e9e06e4 100644 --- a/scripts/install.sh +++ b/scripts/install.sh @@ -10,3 +10,5 @@ export NVM_DIR="$([ -z "${XDG_CONFIG_HOME-}" ] && printf %s "${HOME}/.nvm" || pr nvm install node npm i -g antora + +npm install asciidoctor asciidoctor-kroki \ No newline at end of file