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default __webpack_public_path__ + \"static/media/formula.f0f85248.svg\";","import React from 'react';\nimport './Header.css';\nimport Typography from '@material-ui/core/Typography';\n\nconst Header = (props) => {\n\n \n \n return (\n
\n {props.title}\n
\n );\n}\n\nexport default Header;","import React from 'react';\nimport './Welcome.css';\nimport Button from '@material-ui/core/Button';\nimport Typography from '@material-ui/core/Typography';\nimport { Link as RouterLink } from 'react-router-dom';\n\nconst Welcome = (props) => {\n\n const monthArray = [\n \"January\", \n \"February\",\n \"March\", \n \"April\",\n \"May\",\n \"June\",\n \"July\",\n \"August\",\n \"September\",\n \"October\",\n \"November\",\n \"December\", \n ]\n\n const today = new Date();\n const date = `${today.getDate()} ${monthArray[today.getMonth()]} ${today.getFullYear()}`;\n\n return (\n
\n Today is {date}\n \n \n Who should use this calculator?\n This calculator has been designed to provide individualised dosing and monitoring guidance for patients prescribed enoxaparin at The Prince Charles Hospital based upon local guidelines.\n When to use this calculator?\n Use this calculator for any patient prescribed subcutaneous enoxaparin. The calculator will provide patient individualised dosing and monitoring guidance based upon the calculated creatinine clearance (CrCl).\n Disclaimer: This calculator has been designed to provide decision support for clinicians to support the safe prescribing and monitoring of enoxaparin. The suggested guidelines should be considered in the context of the patient’s clinical condition, comorbidities and other medicines prescribed. Consult a specialist for further advice.\n \n The decision support included within this calculator is based upon TPCH Safe use of enoxaparin procedure. \n Additional information relating to enoxaparin is available within the Product Information and Statewide \n Guidelines for Anticoagulation and Prophylaxis using Low Molecular Weight Heparin (LMWH) in adult patients.\n \n \n
\n )\n}\n\nexport default Welcome;","import React from \"react\";\n\nconst CrclContext = React.createContext();\n\nexport default CrclContext;\n","import React, { useContext } from \"react\";\nimport \"./Calculator.css\";\n\nimport Grid from \"@material-ui/core/Grid\";\nimport Button from \"@material-ui/core/Button\";\nimport ToggleButtonGroup from \"@material-ui/lab/ToggleButtonGroup\";\nimport ToggleButton from \"@material-ui/lab/ToggleButton\";\nimport Typography from \"@material-ui/core/Typography\";\nimport FormHelperText from \"@material-ui/core/FormHelperText\";\nimport TextField from \"@material-ui/core/TextField\";\nimport { useForm, Controller } from \"react-hook-form\";\nimport { withRouter } from \"react-router-dom\";\nimport CrclContext from \"../contexts/CrclContext\";\nimport { DataUsageSharp } from \"@material-ui/icons\";\n\nconst Calculator = (props) => {\n const crclcontext = useContext(CrclContext);\n\n function calculateIdealWeight(height, sex) {\n //calculate ideal weight = (height-152)*0.9+50\n return Number(((height - 152) * 0.9 + (sex === \"male\" ? 50 : 45.5)).toFixed(3));\n }\n\n function calculateCrCl(age, weight, creatinine, sex){\n let crcl = ((140 - age) * weight) / (0.814 * creatinine);\n return sex === \"male\" ? crcl : crcl * .85;\n }\n\n function getCrClSub(crcl){\n if (crcl > 50) {\n return \"\";\n } else if (crcl < 50 && crcl >= 30) {\n return \"Moderate renal impairment\";\n } else if (crcl < 30 && crcl >= 0.1) {\n return \"Severe renal impairment\";\n }\n }\n\n function getCrClSubClass(crcl){\n if (crcl > 50) {\n return \"green\";\n } else if (crcl < 50 && crcl >= 30) {\n return \"yellow\";\n } else if (crcl < 30 && crcl >= 0.1) {\n return \"red\";\n }\n }\n\n const calculate = (e, data) => {\n //Validation text\n let validationText = {};\n let alertDialog = false;\n let alertDialogText = [];\n let alertTitle = \"\";\n\n //Start of calculations\n let idealWeight;\n let crcl;\n let crclIdeal;\n let crclSub;\n let crclClass;\n let crclSubActual;\n let crclSubIdeal;\n let anticoagulationText = [];\n let prophylaxisText = [];\n let prophylaxisDose;\n\n idealWeight = calculateIdealWeight(data.height, data.sex);\n\n //Calculate CrCl\n crcl = calculateCrCl(data.age, data.weight, data.creatinine, data.sex);\n crclIdeal = calculateCrCl(data.age, idealWeight, data.creatinine, data.sex);\n\n // DG TESTING\n console.log('weight', data.weight);\n console.log('idealWeight', idealWeight);\n console.log('crcl', crcl);\n console.log('crclIdeal', crclIdeal);\n\n //Define CrCl warning text\n const lowerCrCl = Math.min(crcl, crclIdeal);\n crclSub = getCrClSub(lowerCrCl);\n crclClass = getCrClSubClass(lowerCrCl);\n crclSubIdeal = getCrClSub(crclIdeal);\n crclSubActual = getCrClSub(crcl);\n\n // New structure\n // Full Anti-Coagulation\n const weightOutsideRange = (data.weight < 50 || data.weight > 105);\n const severeRenalText =

as patient has severe renal impairment.

;\n const severeRenalWeightText =

as patient has severe renal impairment and is underweight, overweight or obese. CrCl estimates may also be inaccurate and evidence for use of enoxaparin is limited at extremes of body weight.

;\n const severeRenalHeparinText = [\n Use IV Heparin\n ,\n weightOutsideRange ? severeRenalWeightText : severeRenalText,\n \n IV HEPARIN\n ,\n \n

\n IV Heparin treatment dose and monitoring is to occur in accordance\n with\n

\n

\n \n Adult Heparin intravenous infusion order and administration form\n \n

\n ,\n\n \n ENOXAPARIN\n ,\n \n

Enoxaparin treatment dose based upon consultant advice.

\n

\n If enoxaparin is selected, discuss with consultant prior to\n prescribing.\n

\n

\n \n Documented consultant approval is required for therapeutic\n enoxaparin use in patients if CrCl less than 30mL/min.\n \n

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

\n If enoxaparin is used, and treatment is to be continued beyond 48\n hours:\n

\n ,\n \n Measure anti-factor Xa level (4hours post dose) after 3rd or 4th\n dose (to coincide with laboratory hours) and then measure every\n second day.\n ];\n\n const dosageText = [\n Use Enoxaparin or IV Heparin\n ,\n \n \n ENOXAPARIN
TREATMENT DOSE IS\n \n ,\n \n {Math.round((data.weight - 1) / 10) * 10} mg TWICE DAILY\n ,\n \n

Round weight to nearest 10kg when dosing and round down if interval of 5kg

\n ];\n\n const moderateRenalMonitoringText = [\n ENOXAPARIN MONITORING\n ,\n \n

If treatment is to be continued beyond 48 hours:

\n ,\n \n Measure anti-factor Xa level (4hours post dose) after 3rd or 4th\n dose (to coincide with laboratory hours) and then measure every\n second day.\n ,\n \n

\n Strongly consider IV heparin in extremes of body size, severe\n liver disease, diseases of skeletal muscle and elderly patients\n with low body weight (as CrCl may be inaccurate).\n

\n

\n Use IV heparin if anti-factor Xa measurements are unavailable or\n renal function is unstable (e.g. acute kidney failure).\n

\n ,\n \n IV HEPARIN\n ,\n \n

\n IV Heparin treatment dose and monitoring is to occur in accordance\n with\n

\n

\n \n Adult Heparin intravenous infusion order and administration form\n \n

\n ];\n\n const minorRenalMonitoringText = [\n ENOXAPARIN MONITORING\n ,\n \n

If treatment is to be continued beyond 5 days:

\n ,\n \n Measure anti-factor Xa level (4hours post dose) on day 5\n (to coincide with laboratory hours) and then measure every\n second day.\n ,\n\n \n

\n Strongly consider IV heparin in extremes of body size, severe\n liver disease, diseases of skeletal muscle and elderly patients\n with low body weight (as CrCl may be inaccurate).\n

\n

\n Use IV heparin if anti-factor Xa measurements are unavailable or\n renal function is unstable (e.g. acute kidney failure).\n

\n ,\n \n IV HEPARIN\n ,\n \n

\n IV Heparin treatment dose and monitoring is to occur in accordance\n with\n

\n

\n \n Adult Heparin intravenous infusion order and administration form\n \n

\n ];\n\n const weightOutsideRangeText = [\n IV Heparin is preferred agent\n ,\n \n

\n because patient is underweight, overweight or obese.\n CrCl estimates may also be inaccurate and evidence \n for use of enoxaparin is limited at extremes of body weight.\n

\n ,\n \n IV HEPARIN\n ,\n \n

\n IV Heparin treatment dose and monitoring is to occur in accordance\n with\n

\n

\n \n Adult Heparin intravenous infusion order and administration form\n \n

\n

\n If IV access is not possible, discuss use of enoxaparin with\n consultant prior to prescribing.\n

\n ,\n \n ENOXAPARIN\n ,\n \n

Enoxaparin treatment dose based upon consultant advice.

\n

\n If enoxaparin is selected, discuss with consultant prior to\n prescribing.\n

\n

\n Note: Enoxaparin dose-capping may limit supratherapeutic levels but\n may result in under-dosing. Weight based enoxaparin dosing using\n actual body weight may result in over-dose and bleeding. Ensure\n monitoring if enoxaparin is used.\n

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

If treatment is to be continued beyond 48 hours:

\n ,\n \n Measure anti-factor Xa level (4hours post dose) after 3rd or 4th dose\n (to coincide with laboratory hours) and then measure every second day.\n ]; \n\n if (lowerCrCl < 30) {\n // anticoagulationText.push(weightOutsideRange ? severeRenalWeightText : severeRenalText);\n anticoagulationText.push(severeRenalHeparinText);\n } else if (lowerCrCl >= 30 && lowerCrCl <= 50) {\n weightOutsideRange \n ? anticoagulationText.push(weightOutsideRangeText) \n : anticoagulationText.push(dosageText, moderateRenalMonitoringText);\n } else if (lowerCrCl > 50) {\n weightOutsideRange \n ? anticoagulationText.push(weightOutsideRangeText) \n : anticoagulationText.push(dosageText, minorRenalMonitoringText);\n }\n\n //Prophylaxis\n\n if (crcl > 49 || lowerCrCl > 15) {\n prophylaxisText.push(\n \n \n ENOXAPARIN
\n PROPHYLATIC DOSE{\" \"}\n \n \n );\n }\n\n if (lowerCrCl <= 30) {\n prophylaxisDose = \"20mg\";\n } else if (lowerCrCl > 30) {\n prophylaxisDose = +data.weight > 49 ? \"40mg\" : \"20mg\";\n } else {\n prophylaxisDose = \"20mg\";\n }\n\n // DG Removed condition as seems irrelevant with new spec.\n // Always \"ONCE DAILY\"\n // if (crcl > 49 || lowerCrCl > 15) {\n prophylaxisText.push(\n \n {prophylaxisDose} ONCE DAILY\n \n );\n // }\n\n prophylaxisText.push(\n \n

Use chemoprophylaxis according to VTE risk.

\n ,\n \n

Refer to VTE guidelines.

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

\n Routine monitoring of anti-factor Xa is not recommended for patients\n on enoxaparin prophylaxis.{\" \"}\n

\n

\n If any significant bleeding occurs, enoxaparin should be stopped and\n urgent consultant review organised. Anti-factor Xa measurement may\n assist with management.\n

\n \n );\n\n //Validation warning that don't block the calculation\n if (\n data.weight > 200 ||\n data.height < 152 ||\n data.height > 200 ||\n data.age > 100 ||\n lowerCrCl < 60\n ) {\n alertDialog = true;\n\n alertTitle = \"Warning\";\n alertDialogText.push(\n \n \n Prior to prescribing or administering an anticoagulant, please\n ensure duplication of therapeutic anticoagulation does not occur.\n\n If the patient is already on an anticoagulant, \n check for appropriate changeover and administration times.\n \n ,\n );\n }\n\n validationText = {\n warningText: alertDialogText,\n };\n\n crclcontext.update({\n validationText: validationText,\n alertDialog: alertDialog,\n alertTitle: alertTitle,\n crcl: crcl.toFixed(1),\n crclIdeal: crclIdeal.toFixed(1),\n crclSub: crclSub,\n crclClass: crclClass,\n crclSubActual: crclSubActual,\n crclSubIdeal: crclSubIdeal,\n idealWeight: idealWeight,\n anticoagulationText: anticoagulationText,\n prophylaxisText: prophylaxisText,\n });\n\n e.preventDefault();\n props.history.push(\"/results\");\n };\n\n const defaultValues = {\n age: '',\n weight: '',\n height: '',\n creatinine: '',\n };\n\n const { handleSubmit, register, errors, setValue, reset, control } = useForm({\n mode: \"onChange\",\n defaultValues: defaultValues,\n });\n\n const onSubmit = (data, e) => {\n if (!data.sex || data.sex === null) {\n let validationText = { sexHelperText: \"Select a sex\" };\n crclcontext.update({ validationText: validationText, ...data });\n return;\n }\n crclcontext.update({ ...data });\n calculate(e, data);\n };\n\n const [sex, setSex] = React.useState(() => crclcontext.sex);\n const handleSex = (e, newSex) => {\n setSex(newSex);\n setValue(\"sex\", newSex);\n };\n\n React.useEffect(() => {\n register(\"sex\");\n }, [register]);\n\n React.useEffect(() => {\n const formData = { ...crclcontext };\n setValue(\"sex\", formData.sex);\n setValue(\"age\", formData.age);\n setValue(\"weight\", formData.weight);\n setValue(\"height\", formData.height);\n setValue(\"creatinine\", formData.creatinine);\n }, [setValue, crclcontext]);\n\n const resetHandler = () => {\n handleSex({}, null);\n reset();\n };\n\n return (\n
\n \n All fields are required.\n \n \n Sex *\n \n
\n \n \n \n \n Male\n \n \n Female\n \n \n \n {crclcontext.validationText.sexHelperText}\n \n \n \n }\n control={control}\n name=\"age\"\n label=\"Age\" \n type=\"number\" \n variant=\"filled\"\n fullWidth\n required\n rules={{\n min: { value: 18, message: \"Enter an age above 18\" },\n max: { value: 100, message: \"Enter an age below 100\" },\n }}\n error={errors.age ? true : false}\n helperText={errors.age?.message}\n />\n \n \n \n }\n control={control}\n name=\"weight\"\n label=\"Weight (kg)\" \n type=\"number\"\n variant=\"filled\"\n fullWidth\n required\n rules={{\n min: { value: 20, message: \"Weight is too low\" },\n max: { value: 500, message: \"Weight is too high\" },\n }}\n error={errors.weight ? true : false}\n helperText={errors.weight?.message}\n />\n \n \n \n }\n control={control}\n name=\"height\"\n label=\"Height (cm)\" \n type=\"number\"\n variant=\"filled\"\n fullWidth\n required\n rules={{\n min: { value: 152, message: \"Height is too low\" },\n max: { value: 300, message: \"Height is too high\" },\n }}\n error={errors.height ? true : false}\n helperText={errors.height?.message}\n />\n \n \n \n }\n control={control}\n name=\"creatinine\"\n label=\"Serum creatinine (umol/L)\" \n type=\"number\"\n variant=\"filled\"\n fullWidth\n required\n rules={{}}\n error={errors.creatinine ? true : false} \n helperText={errors.creatinine?.message} \n />\n \n \n \n Reset\n \n \n \n \n
\n
\n );\n};\n\nexport default withRouter(Calculator);\n","import React, { useState } from \"react\";\n\nimport { makeStyles } from \"@material-ui/core/styles\";\nimport Card from \"@material-ui/core/Card\";\nimport CardContent from \"@material-ui/core/CardContent\";\nimport Typography from \"@material-ui/core/Typography\";\n\nimport clsx from \"clsx\";\nimport Collapse from \"@material-ui/core/Collapse\";\nimport IconButton from \"@material-ui/core/IconButton\";\nimport ExpandMoreIcon from \"@material-ui/icons/ExpandMore\";\n\nconst useStyles = makeStyles((theme) => ({\n card: {\n marginTop: 20,\n marginBottom: 20,\n },\n expand: {\n float: \"right\",\n padding: 15,\n transform: \"rotate(0deg)\",\n marginLeft: \"auto\",\n transition: theme.transitions.create(\"transform\", {\n duration: theme.transitions.duration.shortest,\n }),\n },\n expandOpen: {\n transform: \"rotate(180deg)\",\n },\n cardTitle: {\n //height: 18,\n width: 250,\n paddingBottom: \"0px !important\",\n },\n}));\n\nconst CardCollapseMini = ({title, content}) => {\n const classes = useStyles();\n\n const [expanded, setExpanded] = useState(false);\n const handleExpandClick = () => setExpanded(previousState => !previousState);\n\n return (\n
\n \n \n \n \n \n {title}\n \n \n {content}\n \n \n
\n );\n};\n\nexport default CardCollapseMini;\n","import React from 'react'\nimport './DialogFullScreen.css'\n\nimport { makeStyles } from '@material-ui/core/styles';\nimport Button from '@material-ui/core/Button';\nimport Dialog from '@material-ui/core/Dialog';\nimport AppBar from '@material-ui/core/AppBar';\nimport Toolbar from '@material-ui/core/Toolbar';\nimport IconButton from '@material-ui/core/IconButton';\nimport Typography from '@material-ui/core/Typography';\nimport KeyboardBackspaceIcon from '@material-ui/icons/KeyboardBackspace';\nimport Slide from '@material-ui/core/Slide';\n\nconst useStyles = makeStyles((theme) => ({\n appBar: {\n position: 'relative',\n },\n title: {\n marginLeft: theme.spacing(2),\n flex: 1,\n },\n button: {\n width: '100%',\n marginBottom: 20,\n textAlign: 'left',\n },\n content: {\n padding: 20,\n },\n dialogFullScreen: {\n maxWidth: 1200,\n margin: \"auto\",\n },\n}));\n\nconst Transition = React.forwardRef(function Transition(props, ref) {\n return ;\n});\n\nconst DialogFullScreen = (props) => {\n\n const classes = useStyles();\n const [open, setOpen] = React.useState(false);\n\n const handleClickOpen = () => {\n setOpen(true);\n };\n \n const handleClose = () => {\n setOpen(false);\n };\n\n\n return(\n
\n \n \n \n \n \n \n \n \n {props.title}\n \n \n \n
\n {props.content}\n
\n \n
\n )\n}\n\nexport default DialogFullScreen;\n","import React from 'react';\nimport './Highlight.css';\n\nimport { makeStyles } from '@material-ui/core/styles';\nimport EmojiObjectsIcon from '@material-ui/icons/EmojiObjects';\nimport ErrorIcon from '@material-ui/icons/Error';\nimport List from '@material-ui/core/List';\nimport ListItem from '@material-ui/core/ListItem';\nimport ListItemIcon from '@material-ui/core/ListItemIcon';\nimport ListItemText from '@material-ui/core/ListItemText';\n\nconst useStyles = makeStyles((theme) => ({\n highlight: {\n paddingLeft: 0,\n },\n highlightIcon: {\n minWidth: 40,\n },\n\n}));\n\nconst Highlight = (props) => {\n const classes = useStyles();\n let icon;\n\n if (props.type === \"attention\"){\n icon = ; \n } else if (props.type === \"warning\"){\n icon = ; \n }\n\n return (\n \n \n \n {icon}\n \n \n \n \n );\n}\n\nexport default Highlight;","import React, { useContext } from \"react\";\nimport \"./Results.css\";\n\nimport clsx from 'clsx';\nimport { makeStyles } from \"@material-ui/core/styles\";\nimport Card from \"@material-ui/core/Card\";\nimport CardActions from \"@material-ui/core/CardActions\";\nimport CardContent from \"@material-ui/core/CardContent\";\nimport Collapse from \"@material-ui/core/Collapse\";\nimport ExpandMoreIcon from '@material-ui/icons/ExpandMore';\nimport Button from \"@material-ui/core/Button\";\nimport Typography from \"@material-ui/core/Typography\";\n//import CardCollapse from \"../../../components/CardCollapse/CardCollapse\";\nimport CardCollapseMini from \"../../../components/CardCollapseMini/CardCollapseMini\";\nimport DialogFullScreen from \"../../../components/DialogFullScreen/DialogFullScreen\";\nimport Highlight from \"../../../components/Highlight/Highlight\";\nimport Paper from \"@material-ui/core/Paper\";\nimport Divider from \"@material-ui/core/Divider\";\nimport { withRouter } from \"react-router\";\n\nimport CrclContext from \"../contexts/CrclContext\";\nimport { IconButton } from \"@material-ui/core\";\n\nconst useStyles = makeStyles((theme) => ({\n card: {\n marginTop: 20,\n marginBottom: 20,\n },\n estimatesHeading: {\n display: 'flex'\n },\n expand: {\n padding: 0,\n transform: 'rotate(0deg)',\n marginLeft: 'auto',\n transition: theme.transitions.create('transform', {\n duration: theme.transitions.duration.shortest,\n }),\n },\n expandOpen: {\n transform: 'rotate(180deg)',\n },\n title: {\n fontSize: 14,\n },\n references: {\n backgroundColor: \"#EAFAFD\",\n padding: 20,\n },\n highlight: {\n paddingLeft: 0,\n },\n highlightIcon: {\n minWidth: 40,\n },\n divider: {\n marginTop: 20,\n marginBottom: 20,\n },\n dividerFormula: {\n marginTop: 2,\n marginBottom: 2,\n backgroundColor: \"#000000\",\n width: \"250px\",\n },\n heading: {\n marginBottom: 20,\n },\n image: {\n padding: 20,\n },\n topButtom: {\n color: \"default\",\n width: \"100%\",\n },\n}));\n\nconst Results = (props) => {\n const crclcontext = useContext(CrclContext);\n const classes = useStyles();\n\n const backToCalc = (e) => {\n e.preventDefault();\n props.history.push(\"/calculator\");\n };\n \n const [estExpanded, setEstExpanded] = React.useState(false);\n\n const handleExpandClick = () => {\n setEstExpanded(!estExpanded);\n };\n\n let cockcroft = [\n
,\n \n

\n The Cockcroft-Gault equation estimates CrCl in mL/minute and has \n been successfully used in the calculation of drug doses in adults \n with renal impairment.\n

\n ,\n \n ADULT MALES\n ,\n \n [140 - age] x ideal body weight (kg)\n ,\n ,\n \n 0.814 x serum creatinine (micromol/L)\n ,\n \n ADULT FEMALES\n ,\n Multiply above equation by 0.85,\n \n

\n For more detailed information on how to adjust drug doses in chronic\n kidney disease see:\n https://www.nps.org.au/australian-prescriber/articles/how-to-adjust-drug-doses-in-chronic-kidney-disease\n

\n ,\n ];\n\n let dosingGuidelines = [\n Full anticoagulation,\n \n Use IV Heparin\n ,\n

as patient has severe renal impairment.

,\n \n IV HEPARIN\n ,\n \n

\n IV Heparin treatment dose and monitoring is to occur in accordance\n with\n

\n

\n \n Adult Heparin intravenous infusion order and administration form\n \n

\n ,\n \n ENOXAPARIN\n ,\n \n

Enoxaparin treatment dose based upon consultant advice.

\n

\n If enoxaparin is selected, discuss with consultant prior to\n prescribing.\n

\n

\n \n Documented consultant approval is required for therapeutic\n enoxaparin use in patients if CrCl less than 30mL/min.\n \n

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

\n If enoxaparin is used, and treatment is to be continued beyond 48\n hours:\n

\n

\n Measure anti-factor Xa level (4hours post dose) after 3rd or 4th\n dose (to coincide with laboratory hours) and then measure every\n second day.\n

\n ,\n ]}\n />,\n \n Use Enoxaparin or IV Heparin\n ,\n \n \n ENOXAPARIN
TREATMENT DOSE IS\n \n ,\n \n 1mg/kg TWICE DAILY\n ,\n \n

Round weight to nearest 10kg when dosing and round down if interval of 5kg

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

If treatment is to be continued beyond 48 hours:

\n

\n Measure anti-factor Xa level (4hours post dose) after 3rd or 4th\n dose (to coincide with laboratory hours) and then measure every\n second day.\n

\n

\n Strongly consider IV heparin in extremes of body size, severe liver\n disease, diseases of skeletal muscle and elderly patients with low\n body weight (as CrCl may be inaccurate).\n

\n

\n Use IV heparin if anti-factor Xa measurements are unavailable or\n renal function is unstable (e.g. acute kidney failure).\n

\n ,\n \n IV HEPARIN\n ,\n \n

\n IV Heparin treatment dose and monitoring is to occur in accordance\n with\n

\n

\n \n Adult Heparin intravenous infusion order and administration form\n \n

\n ,\n ]}\n />,\n \n IV Heparin is preferred agent\n ,\n \n

\n because patient is underweight, overweight or obese\n CrCl estimates may also be inaccurate and evidence \n for use of enoxaparin is limited at extremes of body weight.\n

\n ,\n \n IV HEPARIN\n ,\n \n

\n IV Heparin treatment dose and monitoring is to occur in accordance\n with\n

\n

\n \n Adult Heparin intravenous infusion order and administration form\n \n

\n

\n If IV access is not possible, discuss use of enoxaparin with\n consultant prior to prescribing.\n

\n ,\n \n ENOXAPARIN\n ,\n \n

Enoxaparin treatment dose based upon consultant advice.

\n

\n If enoxaparin is selected, discuss with consultant prior to\n prescribing.\n

\n

\n Note: Enoxaparin dose-capping may limit supratherapeutic levels but\n may result in under-dosing. Weight based enoxaparin dosing using\n actual body weight may result in over-dose and bleeding. Ensure\n monitoring if enoxaparin is used.\n

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

If treatment is to be continued beyond 48 hours:

\n

\n Measure anti-factor Xa level (4hours post dose) after 3rd or 4th\n dose (to coincide with laboratory hours) and then measure every\n second day.\n

\n ,\n ]}\n />,\n ]}\n />,\n \n Use Enoxaparin or IV Heparin\n ,\n \n \n ENOXAPARIN
TREATMENT DOSE IS\n \n ,\n \n 1mg/kg TWICE DAILY\n ,\n \n

Round weight to nearest 10kg when dosing and round down if interval of 5kg

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

If treatment is to be continued beyond 5 days:

\n

\n Measure anti-factor Xa level (4hours post dose) after 3rd or 4th\n dose (to coincide with laboratory hours) and then measure every\n second day.\n

\n

\n Strongly consider IV heparin in extremes of body size, severe liver\n disease, diseases of skeletal muscle and elderly patients with low\n body weight (as CrCl may be inaccurate).\n

\n

\n Use IV heparin if anti-factor Xa measurements are unavailable or\n renal function is unstable (e.g. acute kidney failure).\n

\n ,\n \n IV HEPARIN\n ,\n \n

\n IV Heparin treatment dose and monitoring is to occur in accordance\n with\n

\n

\n \n Adult Heparin intravenous infusion order and administration form\n \n

\n ,\n ]}\n />,\n \n IV Heparin is preferred agent\n ,\n \n

\n because patient is underweight, overweight or obese\n CrCl estimates may also be inaccurate and evidence \n for use of enoxaparin is limited at extremes of body weight.\n

\n ,\n \n IV HEPARIN\n ,\n \n

\n IV Heparin treatment dose and monitoring is to occur in accordance\n with\n

\n

\n \n Adult Heparin intravenous infusion order and administration form\n \n

\n

\n If IV access is not possible, discuss use of enoxaparin with\n consultant prior to prescribing.\n

\n ,\n \n ENOXAPARIN\n ,\n \n

Enoxaparin treatment dose based upon consultant advice.

\n

\n If enoxaparin is selected, discuss with consultant prior to\n prescribing.\n

\n

\n Note: Enoxaparin dose-capping may limit supratherapeutic levels but\n may result in under-dosing. Weight based enoxaparin dosing using\n actual body weight may result in over-dose and bleeding. Ensure\n monitoring if enoxaparin is used.\n

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

If treatment is to be continued beyond 48 hours:

\n

\n Measure anti-factor Xa level (4hours post dose) after 3rd or 4th\n dose (to coincide with laboratory hours) and then measure every\n second day.\n

\n ,\n ]}\n />,\n ]}\n />,\n Prophylaxis,\n \n \n ENOXAPARIN
\n PROPHYLATIC DOSE{\" \"}\n \n ,\n \n 20mg ONCE DAILY\n ,\n \n

Use chemoprophylaxis according to VTE risk.

\n ,\n \n

Refer to VTE guidelines.

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

\n Routine monitoring of anti-factor Xa is not recommended for patients\n on enoxaparin prophylaxis.{\" \"}\n

\n

\n If any significant bleeding occurs, enoxaparin should be stopped and\n urgent consultant review organised. Anti-factor Xa measurement may\n assist with management.\n

\n ,\n ]}\n />,\n \n \n ENOXAPARIN
\n PROPHYLATIC DOSE{\" \"}\n \n ,\n \n 20mg ONCE DAILY\n ,\n \n

Use chemoprophylaxis according to VTE risk.

\n ,\n \n

Refer to VTE guidelines.

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

\n Routine monitoring of anti-factor Xa is not recommended for patients\n on enoxaparin prophylaxis.{\" \"}\n

\n

\n If any significant bleeding occurs, enoxaparin should be stopped and\n urgent consultant review organised. Anti-factor Xa measurement may\n assist with management.\n

\n ,\n ]}\n />,\n \n \n ENOXAPARIN
\n PROPHYLATIC DOSE{\" \"}\n \n ,\n \n 40mg ONCE DAILY\n ,\n \n

Use chemoprophylaxis according to VTE risk.

\n ,\n \n

Refer to VTE guidelines.

\n ,\n \n ENOXAPARIN MONITORING\n ,\n \n

\n Routine monitoring of anti-factor Xa is not recommended for patients\n on enoxaparin prophylaxis.{\" \"}\n

\n

\n If any significant bleeding occurs, enoxaparin should be stopped and\n urgent consultant review organised. Anti-factor Xa measurement may\n assist with management.\n

\n ,\n ]}\n />\n ]}\n />,\n ];\n\n let doseAdjustments = [\n \n Dose adjustment\n ,\n \n The following equation can be used to assist with enoxaparin dose adjustments. Consider indication, renal function and patient weight when determining dose adjustments.{\" \"}\n ,\n ,\n \n

\n Aim for FOUR hours post dose (peak) level of between 0.5 and 1 anti-factor Xa\n units/mL for twice daily dosing. Usual target level is 0.75 anti-factor Xa units/mL.\n

\n ,\n \n Further advice on dose adjustment can be sought by discussion with consultant, haematologist or clinical pharmacist.\n ,\n ];\n\n let monitoringGuidelines = [\n \n How to monitor enoxaparin?\n ,\n \n

Use anti-factor Xa assay (reported in Auslab as Clexane assay)

\n

\n Blood must be taken{\" \"}\n \n FOUR HOURS post dose (peak) in{\" \"}\n blue top (citrate) tube.\n \n

\n

\n Time the blood level to coincide with haematology laboratory hours (e.g.\n 1200, rather than 2400 for a patient on enoxaparin at 0800 and 2000).\n

\n

\n Aim for FOUR hours post dose (peak) level of between 0.5 and 1 anti-factor Xa\n units/mL for twice daily dosing. Usual target level is 0.75 anti-factor Xa units/mL.\n

\n ,\n ,\n \n Severe renal impairment\n\n

Documented consultant approval is required for therapeutic enoxaparin use in patients if CrCl less than 30mL/min.

\n

\n If enoxaparin is used, and treatment is to be continued beyond 48\n hours, measure anti-factor Xa level (4 hours post dose) after the\n 3rd or 4th dose and then measure every second day.\n

\n ,\n ]}\n />,\n \n Moderate renal impairment\n

\n If enoxaparin is used, and treatment is to be continued beyond 48\n hours, measure anti-factor Xa level (4 hours post dose) after the\n 3rd or 4th dose and then measure every second day \n

\n ,\n ]}\n />,\n \n If enoxaparin treatment is to be continued beyond 5 days, measure\n anti-factor Xa level (4hours post dose) on day 5 (4 hours post dose \n to coincide with laboratory hours) and then measure every second day.\n ,\n ]}\n />,\n \n IV unfractionated heparin is preferred agent in this patient cohort.\n

\n If enoxaparin is used, measure anti-factor Xa level (4 hours post\n dose) after the 3rd or 4th dose and then measure every second day.\n

\n ,\n ]}\n />,\n ];\n\n let reference = [\n \n The decision support included within this calculator is based upon TPCH Safe use of enoxaparin procedure. \n Additional information relating to enoxaparin is available within the Product Information and Statewide \n Guidelines for Anticoagulation and Prophylaxis using Low Molecular Weight Heparin (LMWH) in adult patients.\n \n ];\n // DG Old reference text.\n // \n // References:\n //
    \n //
  1. MIMS Online. Clexane product information. Accessed 11 Sep 2006
    2. \n //
  2. \n // Green B, Duffull S. Development of a dosing strategy for enoxaparin in\n // obese patients. Br J Clin Pharmacol. 2003;56:96-103.\n //
    3. \n //
  3. \n // Kruse MW, Lee JJ. Retrospective evaluation of a pharmacokinetic\n // program for adjusting enoxaparin in renal impairment. Am Heart J. 2004\n // Oct;148:582-9.\n //
    4. \n //
  4. \n // Safe Medication Practice Unit. Patient Safety Alert: Enoxaparin\n // (draft). Mar 2006.\n //
    5. \n //
  5. \n // Roberts GW. Dosing of key renally cleared drugs in the elderly - time\n // to be wary of the eGFR. J Pharm Pract Research. 2006;36:204\n //
    6. \n //
\n // \n\n return (\n
\n \n {(+crclcontext.crcl <= +crclcontext.crclIdeal) && \n \n Estimated CrCl\n Using ACTUAL body weight - {crclcontext.weight} kgs \n \n {crclcontext.crclSub}\n \n \n {crclcontext.crcl} mL/min\n \n \n }\n {(+crclcontext.crclIdeal < +crclcontext.crcl) && \n Using IDEAL body weight - {crclcontext.idealWeight} kgs \n \n {crclcontext.crclSub}\n \n \n {crclcontext.crclIdeal} mL/min\n \n } \n \n \n Re-calculate CrCl\n \n \n \n \n \n \n CrCl Estimates\n \n \n \n \n \n \n Using ACTUAL body weight - {crclcontext.weight} kgs \n \n {crclcontext.crclSubActual}\n \n \n {crclcontext.crcl} mL/min\n \n Using IDEAL body weight - {crclcontext.idealWeight} kgs \n \n {crclcontext.crclSubIdeal}\n \n \n {crclcontext.crclIdeal} mL/min\n \n \n

\n Consult your pharmacist for further advice on use of actual or \n ideal body weight when estimating renal function and medication \n dosing, particularly where estimated renal function is much lower \n when actual body weight is used\n

\n \n \n \n \n\n \n\n \n\n \n\n \n\n \n\n \n\n \n
\n );\n};\n\n\n\nexport default withRouter(Results);\n","import React from 'react';\nimport './Footer.css';\nimport Typography from '@material-ui/core/Typography';\n\nfunction Footer () {\n\n const monthArray = [\n \"January\", \n \"February\",\n \"March\", \n \"April\",\n \"May\",\n \"June\",\n \"July\",\n \"August\",\n \"September\",\n \"October\",\n \"November\",\n \"December\", \n ]\n \n const docUpdated = new Date(document.lastModified),\n date = docUpdated.getDate() + ' ' + monthArray[docUpdated.getMonth()] + ' ' + docUpdated.getFullYear();\n\n return (\n
\n This calculator was designed and developed by the Clinical Skills Development Service.\n Last updated {date}\n
\n )\n}\n\nexport default Footer;","import React, { useContext } from \"react\";\n\nimport Button from \"@material-ui/core/Button\";\nimport Dialog from \"@material-ui/core/Dialog\";\nimport DialogActions from \"@material-ui/core/DialogActions\";\nimport DialogContent from \"@material-ui/core/DialogContent\";\nimport DialogContentText from \"@material-ui/core/DialogContentText\";\nimport DialogTitle from \"@material-ui/core/DialogTitle\";\nimport CrclContext from \"../../containers/Crcl/contexts/CrclContext\";\nimport { withRouter } from \"react-router\";\n\nconst AlertDialog = (props) => {\n const crclcontext = useContext(CrclContext);\n\n const onClose = () => {\n crclcontext.update({ alertDialog: false });\n };\n\n /*const backToCalc = (e) => {\n e.preventDefault();\n props.history.push(\"/calculator\");\n crclcontext.update({ alertDialog: false });\n };*/\n\n return (\n
\n \n \n {crclcontext.alertTitle}\n \n \n \n {crclcontext.validationText.warningText}\n \n \n \n \n {/* {crclcontext.calcStop ? (\n \n ) : (\n
\n \n \n
\n )} */}\n \n \n
\n );\n};\n\nexport default withRouter(AlertDialog);\n","import React, { Component } from 'react';\nimport CrclContext from './CrclContext';\n\nconst DEFAULT_STATE = {\n sex: '',\n age: '',\n weight: '',\n height: '',\n creatinine: '',\n crcl: '',\n crclActual: '',\n crclSub: '',\n crclClass: '',\n crclSubActual: '',\n crclSubIdeal: '',\n idealWeight: '',\n anticoagulationText: '',\n prophylaxisText: '',\n validationText: {},\n alertDialog: false,\n alertTitle: '',\n //calcStop: false,\n};\n\nclass CrclProvider extends Component {\n constructor(props) {\n super(props);\n this.updateState = this.updateState.bind(this);\n this.state = {...DEFAULT_STATE, ...props.state, update: this.updateState, resetState: this.resetState};\n }\n\n updateState(values) {\n this.setState(values);\n }\n\n resetState() {\n this.setState(DEFAULT_STATE);\n }\n\n render() {\n return (\n \n {this.props.children}\n \n );\n }\n}\n\nexport default CrclProvider;\n","import React, { Component } from \"react\";\nimport \"./Crcl.css\";\n\nimport Header from \"../../components/Header/Header\";\nimport Welcome from \"../../containers/Crcl/Welcome/Welcome\";\nimport Calculator from \"../../containers/Crcl/Calculator/Calculator\";\nimport Results from \"../../containers/Crcl/Results/Results\";\nimport Footer from \"../../components/Footer/Footer\";\nimport AlertDialog from \"../../components/AlertDialog/AlertDialog\";\nimport { Route } from \"react-router-dom\";\nimport CrclProvider from \"./contexts/CrclProvider\";\nimport CrclContext from \"./contexts/CrclContext\";\n\nclass Crcl extends Component {\n render() {\n return (\n
\n
\n {/* */}\n \n \n \n \n {/* */}\n
\n
\n );\n }\n}\n\n// Calculator.contextType = CrclContext;\n\nexport default Crcl;\n","import React from \"react\";\nimport \"./App.css\";\nimport \"fontsource-roboto\";\nimport { HashRouter as BrowserRouter } from \"react-router-dom\";\n\nimport Crcl from \"./containers/Crcl/Crcl\";\nimport CrclProvider from \"./containers/Crcl/contexts/CrclProvider\";\n\nfunction App() {\n return (\n \n \n \n \n \n );\n}\n\nexport default App;\n","// This optional code is used to register a service worker.\n// register() is not called by default.\n\n// This lets the app load faster on subsequent visits in production, and gives\n// it offline capabilities. However, it also means that developers (and users)\n// will only see deployed updates on subsequent visits to a page, after all the\n// existing tabs open on the page have been closed, since previously cached\n// resources are updated in the background.\n\n// To learn more about the benefits of this model and instructions on how to\n// opt-in, read https://bit.ly/CRA-PWA\n\nconst isLocalhost = Boolean(\n window.location.hostname === 'localhost' ||\n // [::1] is the IPv6 localhost address.\n window.location.hostname === '[::1]' ||\n // 127.0.0.0/8 are considered localhost for IPv4.\n window.location.hostname.match(\n /^127(?:\\.(?:25[0-5]|2[0-4][0-9]|[01]?[0-9][0-9]?)){3}$/\n )\n);\n\nexport function register(config) {\n if (process.env.NODE_ENV === 'production' && 'serviceWorker' in navigator) {\n // The URL constructor is available in all browsers that support SW.\n const publicUrl = new URL(process.env.PUBLIC_URL, window.location.href);\n if (publicUrl.origin !== window.location.origin) {\n // Our service worker won't work if PUBLIC_URL is on a different origin\n // from what our page is served on. This might happen if a CDN is used to\n // serve assets; see https://github.com/facebook/create-react-app/issues/2374\n return;\n }\n\n window.addEventListener('load', () => {\n const swUrl = `${process.env.PUBLIC_URL}/service-worker.js`;\n\n if (isLocalhost) {\n // This is running on localhost. Let's check if a service worker still exists or not.\n checkValidServiceWorker(swUrl, config);\n\n // Add some additional logging to localhost, pointing developers to the\n // service worker/PWA documentation.\n navigator.serviceWorker.ready.then(() => {\n console.log(\n 'This web app is being served cache-first by a service ' +\n 'worker. To learn more, visit https://bit.ly/CRA-PWA'\n );\n });\n } else {\n // Is not localhost. Just register service worker\n registerValidSW(swUrl, config);\n }\n });\n }\n}\n\nfunction registerValidSW(swUrl, config) {\n navigator.serviceWorker\n .register(swUrl)\n .then(registration => {\n registration.onupdatefound = () => {\n const installingWorker = registration.installing;\n if (installingWorker == null) {\n return;\n }\n installingWorker.onstatechange = () => {\n if (installingWorker.state === 'installed') {\n if (navigator.serviceWorker.controller) {\n // At this point, the updated precached content has been fetched,\n // but the previous service worker will still serve the older\n // content until all client tabs are closed.\n console.log(\n 'New content is available and will be used when all ' +\n 'tabs for this page are closed. See https://bit.ly/CRA-PWA.'\n );\n\n // Execute callback\n if (config && config.onUpdate) {\n config.onUpdate(registration);\n }\n } else {\n // At this point, everything has been precached.\n // It's the perfect time to display a\n // \"Content is cached for offline use.\" message.\n console.log('Content is cached for offline use.');\n\n // Execute callback\n if (config && config.onSuccess) {\n config.onSuccess(registration);\n }\n }\n }\n };\n };\n })\n .catch(error => {\n console.error('Error during service worker registration:', error);\n });\n}\n\nfunction checkValidServiceWorker(swUrl, config) {\n // Check if the service worker can be found. If it can't reload the page.\n fetch(swUrl, {\n headers: { 'Service-Worker': 'script' },\n })\n .then(response => {\n // Ensure service worker exists, and that we really are getting a JS file.\n const contentType = response.headers.get('content-type');\n if (\n response.status === 404 ||\n (contentType != null && contentType.indexOf('javascript') === -1)\n ) {\n // No service worker found. Probably a different app. Reload the page.\n navigator.serviceWorker.ready.then(registration => {\n registration.unregister().then(() => {\n window.location.reload();\n });\n });\n } else {\n // Service worker found. Proceed as normal.\n registerValidSW(swUrl, config);\n }\n })\n .catch(() => {\n console.log(\n 'No internet connection found. App is running in offline mode.'\n );\n });\n}\n\nexport function unregister() {\n if ('serviceWorker' in navigator) {\n navigator.serviceWorker.ready\n .then(registration => {\n registration.unregister();\n })\n .catch(error => {\n console.error(error.message);\n });\n }\n}\n","import { createMuiTheme } from '@material-ui/core/styles';\n\nconst theme = createMuiTheme({\n palette: {\n primary: {\n main: \"#00778C\",\n },\n secondary: {\n main: \"#FFFFFF\",\n },\n error: {\n main: \"#B00020\",\n }\n },\n});\n\nexport default theme;","import React from 'react';\nimport ReactDOM from 'react-dom';\nimport './index.css';\nimport App from './App';\nimport * as serviceWorker from './serviceWorker';\nimport 'fontsource-roboto';\nimport { ThemeProvider } from '@material-ui/core/styles';\nimport theme from './theme';\n\nReactDOM.render(\n \n \n \n \n ,\n document.getElementById('root')\n);\n\n// If you want your app to work offline and load faster, you can change\n// unregister() to register() below. Note this comes with some pitfalls.\n// Learn more about service workers: https://bit.ly/CRA-PWA\nserviceWorker.register();\n"],"sourceRoot":""}