Patient review (anonymous)
Connect the dots: enter results across several days to read direction, rate and pattern rather than a single snapshot. The portal picks the right body weight for creatinine clearance from the actual-to-ideal ratio, judges each change against biological and analytical variation, derives albumin-adjusted calcium, the liver enzyme pattern and the urea:creatinine ratio, stages AKI against the earliest creatinine in the series, checks medications for renal dosing and interactions against BNF/emc-sourced rules, applies sick day rules, detects treatment clusters such as the HFrEF four pillars (NICE NG106), and explores infection guidance with national (NICE) and local pointers. No patient identifiers — parameters only, nothing leaves your browser. Educational aid, not a prescribing system; verify everything against the current BNF, SmPC and local policy.
Patient parameters
Anonymous — no names or identifiers. Everything stays in your browser.
Needed to compute ideal and adjusted body weight — the portal picks the right one for you
Add as many results as you have. Clearance is calculated from the most recent; the earliest becomes the baseline for the AKI check.
A steady-state value predating the results above — used for the AKI check only when fewer than two creatinines have been entered
Renal function
Enter age, sex, weight and creatinine to compute CrCl and eGFR.
Weight basis and creatinine clearance
The weight for Cockcroft–Gault is decided by the actual-to-ideal ratio, not asked.
Enter height and weight to compute ideal and adjusted body weight.
Results over time
One column per day, newest on the right — the layout a cumulative report uses. Nothing is saved; a refresh clears everything.
Fill any boxes below, then add. Re-adding a date overwrites that day's value.
| Analyte | New | Trend |
|---|---|---|
| Creat60–110 µmol/L | — | |
| Urea2.5–7.8 mmol/L | — | |
| Na133–146 mmol/L | — | |
| K3.5–5.1 mmol/L | — | |
| HCO₃22–29 mmol/L | — |
Symptoms and signs
These turn an abnormal number into an explained one. A magnesium of 0.62 is a finding; a magnesium of 0.62 with diarrhoea is a cause, a mechanism and an intervention.
Suggested interventions
What to do, why, and what it was based on — the shape a clinical note needs. Each suggestion checks whether the treatment is already prescribed before proposing it.
No interventions suggested yet. Add electrolyte results, symptoms and signs, and the medication list — the suggestions come from the combination, not from any one of them.
Medications
Renal advice uses CrCl or eGFR per the BNF/SmPC basis for each drug — always verify against the current BNF.
No medications added yet. The built-in list covers common renally-cleared medicines and antibiotics.
Interaction alerts
Add two or more medications to check high-yield interactions.
Electrolytes — last reads
Optional. Values are interpreted against the medication list — e.g. a low K⁺ on a loop diuretic, or a high K⁺ on RAAS blockers.
Reference 3.5–5.3 mmol/L (typical UK range — check local lab)
Reference 133–146 mmol/L (typical UK range — check local lab)
Reference 0.7–1 mmol/L (typical UK range — check local lab)
Enter the most recent potassium, sodium or magnesium if available.
Sick day rules
Tick what applies during acute illness — the medication list is screened against the SADMAN/SADMANS classes to hold while dehydrating illness lasts. Patient leaflet (Notts APC)
Does not apply to minor sickness and diarrhoea — meaning single episodes happening only once (Notts APC v2.0). Source: Notts APC v2.0 (Nov 2025) · KDIGO 2024 PP 4.3.2–4.3.3.
No acute illness selected — nothing to hold right now. Use this to counsel patients on which of their medicines to pause during vomiting, diarrhoea or fever.
Intravenous fluids
Tick what is actually running. The portal totals what those bags deliver over 24 hours and checks it against this patient — composition from NICE CG174, stock list from the West Suffolk formulary §9.2.2.
Inhalers
Tick what the patient is on. Products are matched at ingredient level, because the errors that matter hide inside brand names — Spiolto and Incruse look like two inhalers and are two antimuscarinics.
Treatment group assessment
The medication list is screened for recognisable treatment clusters (e.g. the four HFrEF pillars of NICE NG106). Missing pillars are prescribing opportunities — verify the diagnosis and contraindications before acting.
No treatment clusters detected yet. Add medicines such as ramipril, bisoprolol, spironolactone or dapagliflozin to see the HFrEF group check.
Infection & antibiotic guidance
Likely pathogens, empiric options with rationale, and guideline links. Antibiotic rows are flagged against this patient's renal function where possible.
Likely pathogens
- Gram +Streptococcus pneumoniaeMost common; lancet-shaped diplococci
- Gram −Haemophilus influenzaeCoccobacilli; commoner in COPD
- AtypicalMycoplasma pneumoniaeNo cell wall — beta-lactams ineffective
- AtypicalLegionella pneumophilaConsider if severe, travel, hyponatraemia
- Gram +Staphylococcus aureusClassically post-influenza; can cavitate
Empiric options
- AmoxicillinFirst line
Covers S. pneumoniae, the dominant pathogen in low-severity CAP (NICE NG250).
- Doxycycline or clarithromycinPenicillin allergy
Macrolides/tetracyclines cover atypicals and pneumococcus; used when penicillin-allergic.
- Amoxicillin + clarithromycinAdd-on
Moderate/high-severity CAP: add atypical cover to pneumococcal cover (NG250).
Learning pearls
- Gram-positive cocci in pairs/chains → pneumococcus; in clusters → staphylococcus.
- Atypicals lack a peptidoglycan cell wall, so penicillins and cephalosporins cannot work — you need a macrolide, tetracycline or fluoroquinolone.
- CURB-65 stratifies severity and drives both antibiotic choice and site of care.
Guidelines
NICE NG250 — Pneumonia in adultsAmoxicillin 500 mg TDS for 5 days first line for low-severity CAP; add clarithromycin for moderate severity or suspected atypicals; co-amoxiclav + clarithromycin for high severity.Local guideline
WSFT Respiratory Tract Infections — Antimicrobial Guideline CG10118 (revision last edited 20-4-26)
- Mild (CURB 65 = 0-1): AmoxicillinPO amoxicillin 500mg tds — 5 days
- Mild, penicillin allergy: DoxycyclinePO doxycycline 200mg (day 1) then 100mg od — 5 days (alternative: PO clarithromycin 500mg bd)
- Moderate (CURB 65 = 2): Amoxicillin IVIV amoxicillin 1g tds AND (if atypical pathogens suspected) PO doxycycline 200mg (day 1) then 100mg od — 5 days
- Severe (CURB 65 ≥ 3): Co-amoxiclav + doxycyclineIV co-amoxiclav 1.2g tds AND PO doxycycline 200mg (day 1) then 100mg od — 5-7 days
- Severe, penicillin allergy (not anaphylaxis): Ceftriaxone + doxycyclineIV ceftriaxone 1-2g od AND PO doxycycline 200mg (day 1) then 100mg od — 5-7 days
- Severe, penicillin anaphylaxis: LevofloxacinPO levofloxacin 500mg bd as monotherapy (IV only if not absorbing or NBM); alternative: PO co-trimoxazole 960mg bd AND PO doxycycline 200mg (day 1) then 100mg od — 5-7 days
- Severity is set by CURB 65 (Confusion, Urea >7mmol/l, Resp ≥30/min, BP systolic ≤90 or diastolic ≤60mmHg, age >65).
- If Legionella pneumonia is strongly suspected or the patient cannot have oral/NG treatment, use IV clarithromycin as an alternative to doxycycline.
- WSFT local guidance — verify against the current version on the trust intranet/Microguide.
Analgesia — age and renal adjusted
WSH CG10199 in normal renal function, CG10168 once eGFR falls below 60. The dose interval changes as well as the dose.
Paracetamol
1 g four times daily
No weight or comorbidity trigger for reduction.
Enter an age and a creatinine to get the age-banded opioid dose.
Ward protocols
West Suffolk guidelines, using the age, weight and renal function already entered above. Local policy — verify against the current version before acting.