Selecting the Fluids option will display normal fluid requirements for a child of that weight.
MediKit also gives a breakdown of normal water losses, and a suggested minimum acceptable urine output.
To calculate a suggested fluid resuscitation regime for a dehydrated child, select dehydration and enter the estimated % dehydration.
Selecting the Statistics option will ask you to enter the child's sex and height.
Leave the height at zero to estimate the height (based on the 50th centile for that age).
The statistics screen displays the following data:
Normal physiological parameters
Height and Weight centiles
Body Surface Area (based on weight & height)
Predicted PEFR (based on age & known or estimated height)
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MediKit can calculate doses using named predefined infusion details for calculations.
(Eg. standard Adrenaline, or Dopamine infusions)
At the Enter Infusion Parameters screen, click the Standard Infusions button.
This will display the names of the five predefined infusions. Select the infusion you wish to use and you will be then asked for the weight of the patient and the rate at which you wish to infuse the drug.
Should you wish to define your own drug infusions, select Define your own 'Standard Infusions' data to edit the drug infusion database.
Step through each screen by clicking >>Next until you reach the drug you wish to edit.
Enter the infusion parameters, including a comment to be displayed when the infusion is calculated.
Proceed to the end of the list by clicking >>Next and confirm that you wish to save the information for future use.
Should you wish to restore the infusion data that came with MediKit, click on 'Use MediKit values' when prompted to save the infusion data. Note that selecting this option will erase all information previously entered.
If the infusion information has been altered, the drug infusion section will always start from the Standard Infusions menu. To enter all the details for an infusion (and avoid selecting a specific infusion), select 'Enter all infusion data for calculation'
(Note that the ability to save drug infusion data to disc is limited to the registered version of MediKit.)
Selecting 'Go to Paediatric section' from the main menu (or clicking the Paeds Menu icon on the toolbar) switches to the paediatric section of MediKit.
Navigation within the Paediatric Section
Once presented with the paediatrics screen, select one of the buttons using either the pointer, the shortcut key shown, or the arrow keys and ENTER.
You can also navigate using the menu button.
To return to the main MediKit menu, either press M or click the toolbar Main Menu button.
Selecting Drug Infusions from the main or paediatric menu switches to the drug infusion section of MediKit.
You will be prompted to enter the details of the infusion you wish to give. Don't forget that you can use other units apart from mcg/kg/min by selecting from the options next to 'Units for Rate'.
Selecting 'Details' from the results dialog will show additional information about the infusion.
The Calculations menu contains numerous formula based calculations and assessments.
The list is divided up into medical specialities eg Cardiovascular, Respiratory etc
When you select a calculation, you will be presented with a series of dialogs.
Fill in the parameters shown on the dialog, and press ENTER to take you to the next screen and on to the results for that calculation.
Pressing ESCAPE should take you back to the main menu (this may take more than one key-press for some sections).
Relevant information about specific calculations will be shown on screen, or through the MediKit Guidelines feature.
Title:
2Description:
The first time you use some of the MediKit sections, an 'Info Screen' may pop up to provide you with helpful directions.
You can prevent these screens appearing again by ticking the box provided on the screen.
Use the 'Preferences' menu option to set all the screens to be shown (as if you were running MediKit for the first time).
When you first enter the paediatric section, you will be prompted to enter the age for the child you are dealing with.
If you do not know the weight of the child, leave the weight field at zero and weight will be estimated according to inbuilt age-based formulas.
If you are dealing with a child under 1 year old, click the 'Under 1 year' button, or press ctrl-o to enter the age in either months, weeks or days. Alternatively, use this screen to enter the child's date of birth.
Should you wish to calculate results for a different child, click the New Child button and enter the new age & weight.
To enter weight in pounds & ounces, use the Convert weight menu / toolbar option. The weight you enter will be converted into Kgs and automatically inserted into the New Child screen.
Once within the paediatric section, MediKit does not use the Stored Values section to edit the age / weight of the current child.
(This is because of the complexity of dealing with paediatric ages in years / months / weeks / days).
Table1
Title:
2Description:
bout specific calculations will be shown on screen, or through the MediKit Guidelines feature.
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To save you from entering the same patient details in different calculations, use the Stored Values section to input patient values which will then be automatically entered into subsequent screens.
MediKit can also remember the input values and results from calculations and will use them in other sections of the program as initial values. (eg the result from the last 'converted weight' is automatically entered into any other sections such as the BMI/BSA calculation.)
To directly edit or reset the values held in memory, - click the 'Stored Values' button on the toolbar, or select STORED VALUES from the TOOLS menu.
When a value from a calculation is stored, you will see a message "Storing xxx".
When a 'Stored Value' is inserted into a calculation, you will see a message "Using stored xxx".
Use the 'Preferences' menu option to prevent MediKit 'storing' values from calculations. This means that the 'Stored Values' kept in memory can only be altered by the user by changing them directly on-screen.
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ticular purpose.
Jonathan Perry, February 1999
See 'Paediatric Formulary' in this helpfile for an introduction to user-defined paediatric drugs.
When you begin to define a drug, you are presented with a series of dialogs. Move forward to the next screen by pressing the >>Next button. You can always go back and change previous options by pressing the <<Back button.
Initially you are given two choices for drug you're about to define:
1. If you need to define different doses for different age groups (eg under 1 year old : 10mg/kg, over 1 year old : 20mg/kg) then tick the box provided.
If you simply want to define one dose for all ages then leave this box unticked.
2. If any of the doses you need to define have a dose range with minimum & maximum values, tick on the box provided. Note that MediKit can cope with definitions where some doses are fixed (eg 20mg/kg for one age range), and some are variable (eg 10-20mg/kg for another range). To ensure a dose is defined as fixed, in the later dialogs, fill the minimum field with the dose you need (eg 20mg/kg), and leave the maximum field at zero.
After choosing from these two initial options, click the >>Next button to move on. The next dialog to appear will depend on the choices you've just made.
If you selected 'one dose for all ages', fill in the details of your required definition.
Units and frequency should be selected from the pull down lists.
Click '
' to complete your entry and return to the definition screen.
Different age groups
If you requested 'different age groups', entering the drug definition takes a little more time.
First, choose the number of age groups you need in the next dialog (up to a maximum of 6 age ranges).
You should also complete the details of the doses from this screen - ie units, frequency etc.
Most drugs you define will have the same units and frequency for each age group, however if these vary, select the '(Enter in next page)' option from the pulldown list. You can then select different units / frequencies in the next pages.
Selecting >>Next allows you to enter the doses for each age range.
For each dose, enter the lower limit of that age range, along with the dose for that age range. (And the unit / frequency if you selected this). There's no need to enter the higher limit for the age group, as that will be taken from the limit you give for the next age range. The last age range you enter will be given a maximum age of 12 years.
After you have completed all the dose screens, MediKit will summarise the details of the definition. Check that these are correct and select '
' to complete the definition. (Select <<Back if you wish to change anything).
Additional information
To create a drug with a minimum age limit (eg over 1 year only), initially select the 'different doses for different age groups' option, but enter '1 age group' in the next screen. Select '1 year' in the next screen and enter the dose required. (If you then try to calculate a dose for a child under 1 year, this drug will be shown as 'not recommended')
You can enter a short additional note in the note field which will be displayed beneath the drug dose.
For drugs with a loading and maintenance dose, create two drug definitions, in adjoining slots, and use the note or drug name field to label the loading and maintenance doses.
You can copy / paste drugs between drug slots using the menu or control + c / v
Use the zoom in/out function to change the\
type size of the drug slots
Example definition
To create a drug with the following details:
age 1-3 years: 10mg/kg bd po
age 3 and over: 5mg/kg tds po
start the drug definition by renaming a category and selecting an empty drug slot.
tick the 'different doses for different ages' box, then click >>Next
enter '2' in the 'number of different ages groups' box, enter 'mg/kg' in the 'units' box, then select '(Enter in next page)' from the 'Frequency' list. Complete the list by entering 'po' for 'Admin. route' and click >>Next
On the next screen, enter '1 year' in the 'Range 1: lower age limit' box, and enter '10' for the dose, and 'bd' for frequency
Move down to the 'Range 2: lower age limit' and enter '3 years'. Complete the definition by entering '5' for the dose, 'tds' for the frequency and click >>Next.
The summary screen shown should confirm the data you entered, select '
' to return to the definition screen.
Don't forget to save your changes before using the drug in the paediatric section
A cup of tea would be a suitable reward for successfully following the above instructions
Use the 'Setup' button to customise this calculation.
CHD & Stroke risk are separate risk scores, calculated using two different equations, which use different entry parameters and ranges (see the original papers).
To maximise an entry range you will need to calulate only one of the risks.
Eg. to calculate CHD risk for a 30 year old, select 'Calculate CHD risk only'. This is because the minimum age for Stroke risk calculation is 55
Normally, 5 & 10 year risks are calculated, however you can select 'Enter specific number of years' to force a precise calculation.
Use the '<< Back' button on the 'Results' page to add / remove risk factors (eg smoking) and see their effect on an individual's calculated risk.
As you will see when your first run this section, you are advised to read the original papers (referenced in the 'Guidelines' screen) when using this calulation in a clinical situation.
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MediKit should hopefully be an error free program, however as with all software, there is always the possibility that errors exist.
Should you come across what appears to be an error, should you manage to crash MediKit or if you feel an equation is incorrect, please contact me via email.
If you discover an error, try to include as much detail as you can as to what you were doing at the time, what keystrokes you used, and all of the error message supplied.
The following are expansions of most of the abbreviations used within MediKit:
DRUG FREQUENCY: stat = immediately, od = once per day, bd = 2 x per day, tds = 3 x per day, qds = 4 x per day
DRUG ROUTE: po = oral, im = intramuscular, iv = intravenous, s/c = subcutaneous, pr = per rectum, neb = nebulised
VOLUME: l = litres, dl = decilitres (100mls), ml = millilitres
ENERGY: kJ : kiloJoules, kcal : kiloCalories
WEIGHT: kg = kilograms, g = grams, mg / mgs = milligrams, mcg /
MediKit makes it easier to deal with results and information by using the following features:
Stored Values
Guidelines & References
Results Log
Info Screens
Units Selection
These sections are described in the next part of the help file.
Any Questions?
If you require further information, or have any suggestions for sections to be added to future releases, please email: JJ@Perry.net
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To view the most recent results produced by MediKit, select Results Log from the Tools menu.
To copy a result to the Psion clipboard, click the Select button on the Results Log dialog.
Use the Next Result button to move through the results.
Pressing CTRL+C will copy the selected result to the clipboard.
Where relevant, entry values for calculations can be in either Standard International (SI) or Conventional (American) units. Select 'Change Units' on the data entry screen to toggle the current units.
The units selected for each calculation are recalled the next time the section is used.
Use the preferences option to change the units for all calculations.
To perform direct unit conversions between SI and Conventional, use the 'Units' section in the 'Convert' menu.
New to MediKit from version 2.00 is the ability to create your own paediatric formulary, containing a database of your own user-defined paediatric drug definitions.
You can create up to 8 drug categories, each containing up to 10 drugs. Thus MediKit can deal with up to 80 drug definitions. As you will discover, drug definitions can range from simple to rather complex.
The key concept about the formulary is that it uses two sections:
Drug definitions are created and saved from the Paediatric Formulary section.
Actual drug calculations are then performed from the main Paediatric Section (using the current child's age and weight and the definitions you have created)
To enter the drug definition section, select Define Formulary Drugs from the paediatric File menu, or click the Edit Drugs button on the toolbar.
The drug definition screen is split into two:
The left hand side displays the current drug category. You can change category by clicking on the category button, and selecting from the list provided. (Pressing TAB or 'C' does the same job. The ctrl+left and ctrl+right arrows scroll though the category list)
You can rename categories by clicking on the button provided (Or press 'R')
Before defining a drug, you should rename a category to the appropriate drug class. eg rename 'Category 1' to 'Analgesia' prior to defining 'Codeine'.
The right hand side of the screen displays the 10 available drug definition slots, initially all set to 'undefined'.
To define a specific drug, tap the screen twice on the number box for the slot you wish to fill. Alternatively, use the keyboard arrows to select a drug slot, and press ENTER to define it.
Key points about how MediKit deals with the drug definitions you create:
The drugs you create are read from the paediatric section of MediKit and calculated according to the age / weight of the current child and the dose you have defined.
You need to return to the paediatric section to use the definitions you create.
Categories are only visible from the paediatric section if they contain a drug definition (ie empty categories are not shown)
Drugs defined in drug slots 1-5 will be shown in one screen, drugs in slots 6-10 will are displayed in a second screen.
When you have finished defining drugs, you must save your drugs to disc by selecting SAVE from the FILE menu. This file is then read by MediKit each time you select 'Formulary Drugs' from the Paediatric section.
The file used by MediKit to save drug data is called 'PaedsDrugs' and can be found in the '/System/Apps/MediKit' directory on the drive which MediKit was installed. You can copy this file to someone else's Psion, allowing them access to your own (or your hospital's) paediatric formulary through their copy of MediKit.
Each time you save your formulary, a backup file containing the previous (not the current) formulary is saved. This file is called 'PaedsDrugs.old'. MediKit will automatically use this file if it has problems loading the normal 'PaedsDrugs' file. Use Preferences to prevent the backup file from being saved (if you want to conserve disc space).
The Paediatric formulary will be much quicker to load and save if MediKit is installed to the internal 'C' drive rather than a flashdisk. This is because disc 'read / write' times are much slower than using memory directly.
Until you register MediKit, you are only able to use the first 5 drugs within 'category 1'. You will need to register MediKit to be able to use all 80 definitions.
See the 'Defining Formulary drugs' section in this help-file for a description of the steps needed to define a drug.
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MediKit is frequently updated.
To ensure you have the latest version, please visit the MediKit home page at http://www.palmaris.com or http://JJ.Perry.net
If you want to keep informed of updates, join the MediKit mailing list by emailing Jonathan@palmaris.com or JJ@Perry.net
The shareware version of MediKit may be distributed as the original complete MediKit.zip zipfile containing the following files:
MediKit.app
MediKit.aif
MediKit.mbm
MediKit.hlp
Readme.txt
History.S5
It is a breach of the terms of usage to distribute MediKit in a form other than the original. (ie no files may be added, removed or changed).
The registered version of MediKit must not be distributed.
No charge may be made for distributing MediKit.
You may use the infrared capabilities of EPOC32 systems to transfer the files listed above to another EPOC32 computer, provided all the files are present and in their original form.
Vendors must request permission from the author before including MediKit on archive CDs or other software distribution media.
Please link any website download links to www.JJ.Perry.net or www.palmaris.com rather than keeping a local zipfile. This should keep the latest MediKit version in current circulation.
This program is protected by copyright law and international treaty provisions. You acknowledge that no title to the intellectual property in the software is transferred to you. You further acknowledge that the title and full ownership rights to the software will remain the exclusive property of Jonathan Perry, and you will not acquire any rights to the software. You agree that any copies of the software will contain the same proprietary notices which appear on and in the software.
The equations and mechanisms used to calculate results can be displayed by clicking the Guidelines button, which is usually visible from the results screen of a calculation.
Unregistered users:
Guidelines are only available if MediKit is registered (except for Heparin infusions and Paediatric analgesia, which have been left available as examples)
If you intend to use MediKit in day-day practice, you would be wise to observe the guidelines and equations used to calculate results
See 'MediKit Registration' section of this helpfile for details of how to register.
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A reference source is available for the majority of calculations.
When the Guidelines screen is showing, clicking on the References button will display a reference from which the calculation / assessment was obtained.
MediKit does not provide detailed clinical descriptions pertaining to calculations. If you are not familiar with the use of a particular formula, use the supplied reference to obtain further information. Alternatively, many calculations can be found on the the internet using a recognised search engine.
Unregistered users:
References are only available if MediKit is registered (except for Heparin infusions which has been left available as an example)
See 'MediKit Registration' section of this helpfile for details of how to register.
Select Preferences from the Tools menu to change the following settings within MediKit:
Startup Screen tells MediKit which section to move to when first loaded
Set units for ALL calculations will force all calculations to use 'SI' or 'Conventional' units. Leave this option at 'Don't change' to avoid altering these.
Log Calculation entries to 'Stored Values': de-select this to prevent MediKit from adding calculation entries & calculation results to the 'Stored Values' section. This prevents MediKit from inserting previously calculated values into calculation input screens.
Reset all 'INFO screens' to 'Unseen': tick this box to reset all popup 'Info Screens' to be shown (as if you were running MediKit for the first time)
Keep saved program files on: C / D Drive: this option is available if MediKit is installed to the D drive. It allows you to select which drive the `infusions` and `paediatric drugs` files are kept. Keeping the files on the C (internal) drive can speed up file access and protect from external drive failure.
Paediatric Prefs
Default age for 'New Child' is normally at 'Over 1 year'. Set this to 'Under 1 year' if you usually deal with children whose age is best entered in months / weeks / days or their DOB
Drug frequency labels: allows you to select US or non-US frequency abbreviations.
Keep backup 'Paediatric Formulary' file: de-select this to save disc space, however this will prevent MediKit from attempting to recover from corrupt files
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Assessments
The Assessments menu contains many patient parameter look-up tables.
As with the calculations menu, the list is divided into specialities.
When using assessments with more than one screen, use the <<Back & >>Next buttons to move between screens.
Management
The Management Menu contains other medical calculations specifically concerned with patient management.
Use the Management Menu to access the Drug Infusions section of MediKit.
Preferences
Specific Sections
Most of the calculations performed by MediKit should be self explanatory, however some do need a short description of their use.
These descriptions will not include a clinical explantation of the calculation itself.
Cardiovascular risk scores
Units Selection
Abbreviations
References
Firstly, please read the disclaimer.
MediKit is mostly menu and dialog driven.
Press the menu button (or touch the menu box on the screen) and select a choice from menu provided.
There are five main menu sections:
Calculations
Assessments
Management
Tools
Note that Menu choices with an arrow alongside can be expanded to reveal more options.
In addition to using the 'menu button', tapping the top
of the screen should display the menu, tapping on the lower
should remove it.
The toolbar on the right hand side of the screen will only function when there are no dialogs visible on screen, (as with all Psion programs).
( Revo users: because of the smaller screen size of your machine, opening a menu by clicking an expansion arrow may instantly load the first subsequent menu option before you have a chance to select an choice.
To avoid this, click on the left side of the menu choice. eg For the `Psychiatric` choice under `Assessments` menu, click on the first letter `P` rather than the last `c` )
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Selecting Preset Drugs will present a menu of various drug categories. Select a category and doses of the more commonly used drugs in that field will be displayed.
Note that the drugs listed under Preset Drugs are fixed, and their definitions cannot be changed by the user. If you wish to define your own drug definitions, see the Paediatric Formulary section.
At present, the following preset drug types are included:
Analgesics
Antibiotics
Anti-emetics
Anti-asthmatic drugs
Anti-epileptic drugs
Emergency drugs
Pressing G or selecting Guidelines when drug doses are displayed will display the guidelines used to calculate the doses. (This feature is only available if MediKit is registered)
Note that when presented with uncommon drug doses (eg Trimethoprim 66-99 mg bd) you should round the results to a more easily administered dose (eg Trimethoprim 80 mg bd) depending on the clinical situation.
Note.
(The fixed-drug guidelines used in the paediatric section of MediKit have been obtained both from the British National Formulary, the Alder-Hey Paediatric Formulary and APLS guidelines. It is strongly recommended that you ensure that these guidelines conform to any protocols in place for your working environment. If you need to use different protocols, define your own drugs using the Paediatric Formulary section)
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Stored Values
Guidelines
Results Log
Information Screens
Entering child details
Preset Drugs
Blood Count
Select Blood count from the 'Calculations' menu to display a suggested normal FBC / CBC and differential for a child of the currently selected age.
Statistics
Fluid Management
Standard Infusions
Define your own Infusions
Calculations
Dr Jonathan Perry
Contact me via email:
Jonathan@palmaris.com
or
JJ@Perry.net
The latest version of MediKit should always be available from the following web page:
http://www.palmaris.com
or
http://JJ.Perry.net
If you have any suggestions for improvements to MediKit, or any comments / criticisms, please email either of the above addresses.
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As you probably noticed, this program is not free software.
MediKit is the result of many hundreds of hours of work.
If you continue to use MediKit beyond a 30 day evaluation period, you must register the program.
For a reasonable registration fee you gain the following benefits:
Removal of the tedious nag screens.
The ability to view the Guidelines and References information screens
The ability to save your infusion definitions and the full paediatric formulary.
Entitlement to all future versions of the present major release free (ie all releases from v. 3.00 to 3.99)
Entitlement to support through email.
The ability to add sections to the program that you would find useful. Either through me (tell me what you want) or through you (send me the OPL source code for your routine and I'll try to incorporate it into MediKit). All routines that are incorporated into MediKit will be credited and rewarded with free MediKit registration.
Registering MediKit will also remove any feelings of guilt you may have when using the evaluation version. :)
How to register
1. Register online using US $
You can register online with a recognised credit card using:
http://www.reg.net/product.asp?ID=5718
or follow the links from http://palmaris.com
(Note that this page has links to 'off-line' registration methods (eg. by phone), if you're concerned giving your card number across the internet)
2. Register by post
Please see the MediKit web site at: http://www.palmaris.com or http://JJ.Perry.net and click on Registration for instructions on how to register MediKit by post.
If you have difficulty accessing the above pages, either email JJ@Perry.net for instructions, or write to:
Palmaris Medical Ltd
3 Clifton Road
Crouch End
London N8 8HY
United Kingdom
Once your payment is received, you will receive a registration code (by email) which will unlock your copy of MediKit, converting it to the registered version.
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BMediKit
MediKit is a patient orientated clinical calculator and reference source for your handheld EPOC computer.
MediKit performs hundreds of medical calculations relevant to your patient care, using recognised and referenced algorithms.
Ideal for use on the wards, in casualty / ED or in your clinic / general practice, MediKit can save you time and increase your analytical abilities.
Easy to install and use: navigation between sections is rapid and intuitive.
In continual development with frequent upgrades.
With users from professors to medical students, once you start using MediKit you'll wonder how you coped without it!
While every effort has been made to ensure the accuracy of the contents of the software program 'MediKit', no liability or warranty for errors or omissions exists, expressed or implied.
No responsibility or liability exists, expressed or implied, for any decisions (clinical or otherwise) or actions (or consequences thereof) based on information provided by the program 'MediKit'.
All patient management advice (including drug dose calculations) must be checked with established texts and local guidelines prior to administration.
Normal physiological and laboratory values are presented as general guides. It is essential to validate these with reference texts and your local laboratory.
For some calculations alternative formulas
exist and may yield different results. Please remember this when evaluating the results presented by MediKit.
Note, that by using this software and selecting the YES button on the initial disclaimer screen, you agree to comply with the above conditions of use.
This product is provided without a warranty of any kind. I disclaim all other warranties with respect to the software, either expressed or implied, including, but not limited to, implied warranties of merchantability, and fitness for any particular purpose.
ie. No responsibility can be taken by the author or Palmaris Medical Ltd for any clinical decisions taken on the basis of information contained in MediKit. You're the doctor - you make the call.
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