1109 lines
50 KiB
C#
1109 lines
50 KiB
C#
using adas_core.Application.Services.Interfaces;
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using adas_core.Domain.Enums;
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using adas_core.Domain.Models;
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using adas_core.Domain.Models.AppSettings;
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using adas_core.Domain.Models.MongoModels;
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using adas_core.Domain.Models.Pumps;
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using Microsoft.Extensions.DependencyInjection;
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using Microsoft.Extensions.Logging;
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using Microsoft.Extensions.Options;
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using MongoDB.Bson;
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namespace adas_core.Application.Customizations.HRYC;
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/// <summary>
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/// Implements the HRYC-specific clinical calculations that derive secondary
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/// <see cref="PatientObservation"/> values (NEWS alarms, IROX, Resp_Rate_Calculated, Hydric_Balance_Calculated,
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/// Weight_Diff, Diuresis_Weight, Delta_Pressure, Daily_Balance_Calculated, Allergies, DVE, Drainage_Height,
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/// Resp_Type, and Hour_Balance) from incoming raw observations and active configurations loaded from
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/// <see cref="ApiSettings"/>.
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/// </summary>
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public class CalculatedObservations : ICalculatedObservations
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{
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private readonly IOptions<ApiSettings> _apiSettings;
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private readonly List<string> _codesForInvasiveVentilation = [];
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private readonly IConfigObservationService _configObservationService;
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//private readonly Lazy<IBoxService> _boxService;
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private readonly List<string> _highFrequencyVentilation = [];
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private readonly Lazy<ILightBeaconService> _lightBeaconService;
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private readonly ILogger<CalculatedObservations> _logger;
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private readonly List<string> _nonInvasiveVentilation = [];
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private readonly Lazy<IObservationService> _observationService;
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private readonly Lazy<IPatientService> _patientService;
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/// <summary>
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/// Initializes a new instance of the <see cref="CalculatedObservations"/> class,
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/// resolving its dependencies (observation, patient, light-beacon, and config-observation services,
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/// plus the logger) from the supplied <see cref="IServiceProvider"/> and loading the configured
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/// code catalogues (high-frequency ventilation, non-invasive ventilation, and invasive ventilation)
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/// from <see cref="ApiSettings"/>.
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/// </summary>
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/// <param name="serviceProvider">The application's service provider used to resolve the required dependencies and configuration.</param>
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public CalculatedObservations(IServiceProvider serviceProvider)
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{
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_observationService = serviceProvider.GetRequiredService<Lazy<IObservationService>>(); //observationService;
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_patientService = serviceProvider.GetRequiredService<Lazy<IPatientService>>();
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_apiSettings = serviceProvider.GetRequiredService<IOptions<ApiSettings>>(); //apiSettings;
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//_boxService = serviceProvider.GetRequiredService<Lazy<IBoxService>>();
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_logger = serviceProvider.GetRequiredService<ILogger<CalculatedObservations>>();
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_lightBeaconService = serviceProvider.GetRequiredService<Lazy<ILightBeaconService>>();
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_configObservationService =
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serviceProvider.GetRequiredService<IConfigObservationService>(); //configObservationService;
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var highFrenquencyVentilation = _apiSettings.Value.HighFrequencyVentilation ?? null;
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highFrenquencyVentilation?.ForEach(x => _highFrequencyVentilation.Add(x.Trim()));
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var nonInvasiveVentilation = _apiSettings.Value.NonInvasiveVentilation ?? null;
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nonInvasiveVentilation?.ForEach(x => _nonInvasiveVentilation.Add(x.Trim()));
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var codesForInvasiveVentilation = //TODO comprobar si se refiere a InvasiveVentilation
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_apiSettings.Value.InvasiveVentilation ?? null;
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codesForInvasiveVentilation?.ForEach(x => _codesForInvasiveVentilation.Add(x.Trim()));
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}
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/// <summary>
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/// Dispatches the supplied raw observation to the appropriate HRYC calculation based on its
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/// <see cref="BasePatientObservation.Name"/>. The set of supported calculations includes
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/// <c>Resp_Mode</c> (ventilation type), <c>Diuresis</c> / <c>Weight_Current</c>
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/// (weight difference and diuresis-per-kilogram), <c>AllergiesObs</c>, <c>DrainagesObs</c>,
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/// <c>PEEP</c> / <c>Pleateu_Pressure</c> (driving pressure), <c>Daily_Balance</c>,
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/// <c>Hydric_Balance</c> / <c>Hour_Balance</c> (time shifting), <c>FR</c> / <c>Vent_Rate</c>
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/// (respiratory rate), <c>SpO2</c> / <c>FiO2</c> (IROX), and <c>NEWS</c> (alarms).
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/// </summary>
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/// <typeparam name="T">The concrete observation type, deriving from <see cref="BasePatientObservation"/>.</typeparam>
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/// <param name="obs">The observation to map or transform in-place.</param>
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/// <param name="onlyByName">
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/// Reserved for future use. When <see langword="true"/>, restricts the mapping strategy to
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/// name-based lookups only.
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/// </param>
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/// <returns>
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/// A <see cref="Task{T}"/> that resolves to the (possibly transformed) observation,
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/// or <see langword="null"/> when the input observation has no name.
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/// </returns>
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public async Task<T?> Map<T>(T obs, bool onlyByName) where T : BasePatientObservation
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{
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_logger.LogTrace("Mapping {name} observation {obs}", obs.Name, obs);
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switch (obs.Name)
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{
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case "Resp_Mode":
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_logger.LogTrace("Mapping Resp mode observation {obs}", obs);
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await CalculateVentilationMode(obs);
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break;
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case "Diuresis":
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case "Weight_Current":
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if (obs.Name == "Weight_Current") await CalculateWeight_DiffObservation(obs);
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await CalculateDiureis_WeightObservation(obs);
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break;
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case "AllergiesObs":
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await CalculateAllergiesObservation(obs);
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break;
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case "DrainagesObs":
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await CalculateDrainagesObservation(obs);
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break;
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case "PEEP":
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case "Pleateu_Pressure":
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await CalculateDelta_PressureObservation(obs);
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break;
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case "Daily_Balance":
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await CalculateDaily_BalanceObservation(obs);
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break;
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case "Hydric_Balance":
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await CalculateHydricBalanceCalculated(obs);
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obs = (T)await CalculateHydricBalance(obs);
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break;
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case "Hour_Balance":
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obs = (T)await CalculateHourBalance(obs);
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break;
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case "FR":
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await CalculateRespRate(obs);
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await CalculateIrox(obs);
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break;
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case "Vent_Rate":
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await CalculateRespRate(obs);
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break;
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case "SpO2":
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case "FiO2":
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await CalculateIrox(obs);
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break;
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case "NEWS":
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await CalculateNews(obs);
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break;
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}
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return obs;
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}
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/// <summary>
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/// Placeholder mapping for a <see cref="PatientTreatment"/>. The HRYC customization does not
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/// currently derive observations from treatments.
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/// </summary>
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/// <param name="treatment">The treatment to map.</param>
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/// <returns>Never returns a result.</returns>
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/// <exception cref="NotImplementedException">Always thrown because treatment mapping is not implemented in the HRYC customization.</exception>
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public Task<PatientTreatment> Map(PatientTreatment treatment)
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{
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throw new NotImplementedException();
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}
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/// <summary>
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/// Identity mapping for a <see cref="PumpObservation"/>: returns the supplied instance unchanged,
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/// wrapped in a completed task. Provided to satisfy the customization contract; pump observations
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/// do not require HRYC-specific calculation.
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/// </summary>
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/// <param name="pumpObservation">The pump observation to map.</param>
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/// <returns>A task containing the same <see cref="PumpObservation"/> instance that was passed in.</returns>
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public async Task<PumpObservation> Map(PumpObservation pumpObservation)
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{
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return await Task.FromResult(pumpObservation);
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}
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/// <summary>
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/// No-op implementation of the medicine-observation calculation hook. The HRYC customization does
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/// not derive Medication or ERMedication observations from the active medicine list.
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/// </summary>
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/// <param name="activeMedicines">The list of active medicines (ignored).</param>
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/// <param name="patientId">The unique identifier of the patient (ignored).</param>
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/// <returns>A completed task.</returns>
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public Task CalculateMedicineObservation(List<Medicine> activeMedicines, ObjectId patientId)
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{
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return Task.CompletedTask;
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}
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/// <summary>
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/// No-op implementation of the active-bolus calculation hook. The HRYC customization does not
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/// derive an OpiateBoluses observation.
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/// </summary>
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/// <param name="patientId">The unique identifier of the patient (ignored).</param>
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/// <returns>A completed task.</returns>
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public Task CalculateActiveBolus(ObjectId patientId)
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{
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return Task.CompletedTask;
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}
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/// <summary>
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/// Returns an empty enumerable of active treatments. The HRYC customization does not currently
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/// maintain a per-patient active-treatment cache.
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/// </summary>
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/// <param name="id">The unique identifier of the patient (ignored).</param>
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/// <returns>A completed task containing an empty <see cref="IEnumerable{PatientTreatment}"/>.</returns>
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public Task<IEnumerable<PatientTreatment?>> GetActiveTreatmentsByPatient(ObjectId id)
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{
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return Task.FromResult(new List<PatientTreatment?>().AsEnumerable());
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}
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/// <summary>
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/// Identity mapping for a <see cref="PatientDiagnosis"/>: returns the supplied instance unchanged,
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/// wrapped in a completed task. Provided to satisfy the customization contract.
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/// </summary>
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/// <param name="diagnosis">The <see cref="PatientDiagnosis"/> to map.</param>
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/// <returns>A task containing the same <see cref="PatientDiagnosis"/> instance that was passed in.</returns>
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public Task<PatientDiagnosis> Map(PatientDiagnosis diagnosis)
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{
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return Task.FromResult(diagnosis);
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}
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/// <summary>
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/// Resolves time-inconsistencies for a new patient observation when it arrives with the same
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/// (down-to-the-second) timestamp as the latest stored observation of the same name. The new
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/// observation's <c>Time</c> is shifted forward by one second to avoid duplicate-key collisions.
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/// </summary>
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/// <param name="newObservation">The new patient observation to evaluate for time inconsistencies.</param>
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/// <returns>
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/// A task that resolves to the (possibly time-shifted) <see cref="PatientObservation"/>.
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/// Returns the input unchanged when its <c>Name</c> is null or empty, logging the error.
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/// </returns>
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public async Task<PatientObservation?> FixTimeInconsistencyWithLast(PatientObservation newObservation)
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{
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if (string.IsNullOrEmpty(newObservation.Name))
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{
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_logger.LogError(
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"Error FixTimeInconsistencyWithLast newObservation name ia null or empty. Observation: {newObservation}",
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newObservation);
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return newObservation;
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}
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var lastObservations = await _observationService.Value.FindLastObservations(newObservation.PatientId, 1,
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[newObservation.Name]);
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var lastObservation = lastObservations.FirstOrDefault();
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if (lastObservation != null && DateTime.Compare(
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new DateTime(lastObservation.Time.Year, lastObservation.Time.Month,
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lastObservation.Time.Day, lastObservation.Time.Hour,
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lastObservation.Time.Minute, lastObservation.Time.Second),
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new DateTime(newObservation.Time.Year, newObservation.Time.Month,
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newObservation.Time.Day, newObservation.Time.Hour,
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newObservation.Time.Minute, newObservation.Time.Second)
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) >= 0)
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newObservation.Time = lastObservation.Time.AddSeconds(1);
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return newObservation;
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}
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/// <summary>
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/// Pre-maps a batch of patient observations, optimising the order in which they are persisted
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/// when both <c>Vent_Rate</c> and <c>FR</c> are present. If both observations are present with
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/// non-zero values, <c>Vent_Rate</c> is inserted first (and removed from the returned list) so
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/// that <see cref="CalculateRespRate"/> can derive <c>Resp_Rate_Calculated</c> correctly.
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/// </summary>
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/// <param name="listToInsert">The list of patient observations to pre-map. Modified in-place.</param>
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/// <returns>
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/// A task that resolves to the resulting list of observations (with <c>Vent_Rate</c> removed
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/// when it was inserted synchronously, or the original list otherwise).
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/// </returns>
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public async Task<List<PatientObservation>> PreMapList(List<PatientObservation> listToInsert)
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{
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var ventRate = listToInsert.FirstOrDefault(obs => obs.Name == "MDC_VENT_RESP_RATE");
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var respRate = listToInsert.FirstOrDefault(obs => obs.Name == "MDC_RESP_RATE");
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// Check if obs for Vent_Rate and FR is on the list to insert
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if (ventRate == null || respRate == null) return listToInsert;
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var ventRateValue = double.TryParse(ventRate.Value.ToString(), out var v1) ? v1 : 0;
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// ventRate is on the list to insert but its value is 0
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if (ventRateValue == 0)
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{
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_logger.LogDebug("Find ventRate on PreMap request not processed because its value is 0");
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return listToInsert;
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}
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var respRateValue = double.TryParse(ventRate.Value.ToString(), out var v2) ? v2 : 0;
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// respRate is on the list to insert but its value is 0
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if (respRateValue == 0)
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{
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_logger.LogDebug("Find respRate on PreMap request not processed because its value is 0");
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return listToInsert;
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}
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// Exists both obs and have value != 0
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// In that case we need to calculate Resp_Rate_Calculated just with the value of Vent_Rate
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try
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{
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_logger.LogDebug(
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"Find on PreMap Vent_Rate and FR in the same request process Vent_Rate first to calculate Resp_Rate_Calculated");
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await _observationService.Value.InsertObservation(ventRate);
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listToInsert.Remove(ventRate);
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}
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catch (Exception e)
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{
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_logger.LogError("Error while PreMap on insert obs: {ventRate} exception: {e}", ventRate, e);
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}
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return listToInsert;
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}
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/// <summary>
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/// Identity mapping for a source alarm observation paired with a <see cref="PatientObservationAlarm"/>:
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/// returns the supplied observation unchanged, wrapped in a completed task. Provided to satisfy the
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/// customization contract.
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/// </summary>
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/// <param name="obs">The patient observation that triggered the alarm.</param>
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/// <param name="alarmToInsert">The alarm metadata to be inserted alongside the observation.</param>
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/// <returns>A task containing the same <see cref="PatientObservation"/> instance that was passed in.</returns>
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public Task<PatientObservation> MapSourceAlarm(PatientObservation obs, PatientObservationAlarm alarmToInsert)
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{
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return Task.FromResult(obs);
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}
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/// <summary>
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/// Placeholder alarm dispatch hook used by the customization contract. The HRYC customization
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/// dispatches NEWS alarms through its private <c>SendAlarm(BasePatientObservation, AlarmEnum.Name)</c>
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/// overload; calling this public overload always throws.
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/// </summary>
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/// <param name="obs">The patient observation that triggered the alarm.</param>
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/// <param name="name">The alarm display name.</param>
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/// <param name="code">The optional alarm code from <see cref="AlarmEnum.Name"/>.</param>
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/// <returns>Never returns a result.</returns>
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/// <exception cref="NotImplementedException">Always thrown because this overload is not used in the HRYC customization.</exception>
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public Task SendAlarm(PatientObservation obs, string name, AlarmEnum.Name? code)
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{
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throw new NotImplementedException();
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}
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/// <summary>
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/// Translates a NEWS (National Early Warning Score) value into an alarm level: a value below 5
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/// (or an unparsable value) is reported as <c>NewsOff</c>, between 5 and 7 as <c>NewsWarning</c>,
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/// and 7 or above as <c>NewsAlert</c>. Returns early when the patient cannot be located.
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/// </summary>
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/// <param name="obs">The base patient observation that triggered the calculation, expected to be a <see cref="PatientObservation"/> whose <c>Name</c> is <c>NEWS</c>.</param>
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/// <returns>A task that represents the asynchronous alarm evaluation.</returns>
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private async Task CalculateNews(BasePatientObservation obs)
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{
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var pobs = (PatientObservation)obs;
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var parsed = int.TryParse(pobs.Value.ToString(), out var valueParsed);
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var patient = await _patientService.Value.FindById(obs.PatientId);
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if (patient == null) return;
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//var beaconConfig = await _boxService.Value.GetBeaconConfig(new PatientLocation(patient.PointOfCare, patient.Bed));
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//power off beacon
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//recuperar la beacon del paciente y encenderla apagarla si el valor es > 5&6 o 7 alert
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if ((parsed && valueParsed < 5) || !parsed)
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//await _balizaService.Value.PowerOffLed(beaconCnf);
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//await _observationService.Value.SendObsBroadcast(obs);
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await SendAlarm(obs, AlarmEnum.Name.NewsOff);
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else
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switch (valueParsed)
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{
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case >= 5 and < 7:
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_logger.LogDebug("beacon yellow alert by NEWS for patient: {patientid}", obs.PatientId);
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await SendAlarm(obs, AlarmEnum.Name.NewsWarning);
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//await _balizaService.Value.SendBeaconColor(patient, LightBeaconColor.YELLOW);
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break;
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case >= 7:
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_logger.LogDebug("beacon red alert by NEWS for patient: {patientid}", obs.PatientId);
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await SendAlarm(obs, AlarmEnum.Name.NewsAlert);
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//await _balizaService.Value.SendBeaconColor(patient, LightBeaconColor.RED);
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break;
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}
|
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|
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//if (obsAlarm == null) return;
|
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}
|
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|
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/// <summary>
|
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/// Builds a synthetic <c>Alarm_<Name></c> observation, looks up its configuration, and when
|
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/// the configured alarm and its beacon are enabled, dispatches a light-beacon colour change for
|
||
/// the patient's point-of-care. The alarm observation is always persisted. Errors are logged and
|
||
/// swallowed.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the alarm (used to derive <c>PatientId</c> and <c>Time</c>).</param>
|
||
/// <param name="name">The <see cref="AlarmEnum.Name"/> describing the alarm kind (for example, <c>NewsOff</c>, <c>NewsWarning</c>, <c>NewsAlert</c>).</param>
|
||
/// <returns>A task that represents the asynchronous alarm dispatch.</returns>
|
||
private async Task SendAlarm(BasePatientObservation obs, AlarmEnum.Name name)
|
||
{
|
||
var pobs = (PatientObservation)obs;
|
||
PatientObservation nObs = new()
|
||
{
|
||
CodingSystem = "ADAS_ALARM",
|
||
Code = name.ToString(),
|
||
Name = $"Alarm_{name}",
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PatientId = pobs.PatientId,
|
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Time = pobs.Time
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||
};
|
||
try
|
||
{
|
||
//ConfigObservations
|
||
var configObs = await _configObservationService.Get(new PatientObservation
|
||
{
|
||
Name = nObs.Name,
|
||
PatientId = obs.PatientId
|
||
}
|
||
);
|
||
if (configObs == null)
|
||
{
|
||
_logger.LogError("Config observation is null on send alarm NEWS for {nObs}", nObs);
|
||
return;
|
||
}
|
||
|
||
if (configObs is { Alarm.Enabled: true })
|
||
{
|
||
nObs.Alarm = configObs.Alarm;
|
||
|
||
if (configObs.Alarm.Beacon is { Enabled: true })
|
||
{
|
||
var patient = await _patientService.Value.FindById(obs.PatientId);
|
||
if (patient != null)
|
||
{
|
||
_logger.LogDebug(
|
||
"PatientId: {nObsPatientId}. Send Beacon alarmName {configObsAlarmBeaconBeaconColorValue}",
|
||
nObs.PatientId, configObs.Alarm.Beacon.BeaconColor);
|
||
nObs.Value = configObs.Alarm.Beacon.BeaconColor.ToString();
|
||
SendBeaconCode(configObs.Alarm.Beacon.BeaconColor, patient);
|
||
}
|
||
}
|
||
}
|
||
|
||
_logger.LogDebug(
|
||
"Insert obs alarm for news at: {DateTimeNow} patientId: {nObsPatientId} color value: {nObsValue}",
|
||
DateTime.Now, nObs.PatientId, nObs.Value);
|
||
await _observationService.Value.InsertObservation(nObs);
|
||
}
|
||
catch (Exception ex)
|
||
{
|
||
_logger.LogError("Exception sending alarm: {exMessage}", ex.Message);
|
||
}
|
||
}
|
||
|
||
/// <summary>
|
||
/// Sends a colour command to the light beacon associated with the patient's point-of-care.
|
||
/// Maps <see cref="AlarmEnum.BeaconColor"/> values to <see cref="LightBeaconColor"/> commands
|
||
/// (blue, yellow, red, or off) and logs an error when the patient has no point-of-care identifier.
|
||
/// </summary>
|
||
/// <param name="color">The beacon colour to apply.</param>
|
||
/// <param name="patient">The patient whose associated beacon should be updated.</param>
|
||
private void SendBeaconCode(AlarmEnum.BeaconColor color, Patient patient)
|
||
{
|
||
if (!patient.PointOfCareId.HasValue)
|
||
{
|
||
_logger.LogError("Error sending beacon color on calculateObservations poc id on patient is null {Patient}",
|
||
patient.ToString());
|
||
return;
|
||
}
|
||
|
||
switch (color)
|
||
{
|
||
case AlarmEnum.BeaconColor.Blue:
|
||
_lightBeaconService.Value.SendColor(patient.PointOfCareId.Value, LightBeaconColor.Blue);
|
||
break;
|
||
case AlarmEnum.BeaconColor.Yellow:
|
||
_lightBeaconService.Value.SendColor(patient.PointOfCareId.Value, LightBeaconColor.Yellow);
|
||
break;
|
||
case AlarmEnum.BeaconColor.Red:
|
||
_lightBeaconService.Value.SendColor(patient.PointOfCareId.Value, LightBeaconColor.Red);
|
||
break;
|
||
case AlarmEnum.BeaconColor.None:
|
||
_lightBeaconService.Value.SendColor(patient.PointOfCareId.Value, LightBeaconColor.Off);
|
||
break;
|
||
}
|
||
}
|
||
|
||
/// <summary>
|
||
/// Computes the IROX index (<c>SpO2 / FiO2 / FR</c>) when <c>SpO2</c>, <c>FiO2</c>, and <c>FR</c>
|
||
/// are all present in the latest observations and were recorded within the last 10 minutes.
|
||
/// Persists the resulting <c>IROX</c> observation. Skips silently when any input is missing,
|
||
/// zero, or unparsable. Errors are logged and swallowed.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation (<c>SpO2</c>, <c>FiO2</c>, or <c>FR</c>).</param>
|
||
/// <returns>A task that represents the asynchronous calculation operation.</returns>
|
||
private async Task CalculateIrox(BasePatientObservation obs)
|
||
{
|
||
try
|
||
{
|
||
var pob = (PatientObservation)obs;
|
||
var obsToCalc = new List<PatientObservation> { pob };
|
||
switch (pob.Name)
|
||
{
|
||
case "SpO2":
|
||
|
||
var fio2Frvalues = await _observationService.Value.FindLastObservations(obs.PatientId, 1,
|
||
["FiO2", "FR"]);
|
||
if (fio2Frvalues.Count > 0) obsToCalc.AddRange(fio2Frvalues);
|
||
|
||
break;
|
||
case "FiO2":
|
||
var spo2Frvalues = await _observationService.Value.FindLastObservations(obs.PatientId, 1,
|
||
["SpO2", "FR"]);
|
||
if (spo2Frvalues.Count > 0) obsToCalc.AddRange(spo2Frvalues);
|
||
|
||
break;
|
||
case "FR":
|
||
var fio2Spo2Values = await _observationService.Value.FindLastObservations(obs.PatientId, 1,
|
||
["FiO2", "SpO2"]);
|
||
|
||
if (fio2Spo2Values.Count > 0) obsToCalc.AddRange(fio2Spo2Values);
|
||
|
||
|
||
break;
|
||
}
|
||
|
||
if (!obsToCalc.All(o => o.Time.CompareTo(DateTime.UtcNow.AddMinutes(10)) <= 0)) return;
|
||
|
||
var fio2 = obsToCalc.FirstOrDefault(o => o.Name == "FiO2");
|
||
var fr = obsToCalc.FirstOrDefault(o => o.Name == "FR");
|
||
var spo2 = obsToCalc.FirstOrDefault(o => o.Name == "SpO2");
|
||
if (fio2 == null || fr == null || spo2 == null) return;
|
||
|
||
|
||
if (!double.TryParse(spo2.Value.ToString(), out var nSpo2) ||
|
||
!double.TryParse(fio2.Value.ToString(), out var nFio2) ||
|
||
!double.TryParse(fr.Value.ToString(), out var nFr))
|
||
{
|
||
_logger.LogWarning("Error parsing values. fio2: {fio2}, fr: {fr}, spo2: {spo2}", fio2, fr, spo2);
|
||
return;
|
||
}
|
||
|
||
var spo2Value = nSpo2;
|
||
var fio2Value = nFio2;
|
||
var frValue = nFr;
|
||
|
||
if (spo2Value == 0 || fio2Value == 0 || frValue == 0) return;
|
||
|
||
|
||
var value = nSpo2 / nFio2 / nFr;
|
||
|
||
var irox = new PatientObservation
|
||
{
|
||
Name = "IROX",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = obs.Time,
|
||
Value = value
|
||
};
|
||
await _observationService.Value.InsertObservation(irox);
|
||
}
|
||
catch (Exception e)
|
||
{
|
||
_logger.LogError("Exception calculating IROX, error: {eMessage}", e.Message);
|
||
}
|
||
}
|
||
|
||
|
||
/// <summary>
|
||
/// Persists a <c>Resp_Rate_Calculated</c> observation when the supplied observation's value is
|
||
/// non-zero. For <c>FR</c>, the insert is skipped if a recent (within
|
||
/// <c>CalculateRespRateVentExpires</c> minutes) non-zero <c>Vent_Rate</c> observation exists;
|
||
/// the inserted observation's <c>Time</c> is set to the original <c>Time</c> for <c>FR</c>, or
|
||
/// shifted one second forward for any other name.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation (<c>FR</c> or <c>Vent_Rate</c>).</param>
|
||
/// <returns>A task that represents the asynchronous insert operation.</returns>
|
||
private async Task CalculateRespRate(BasePatientObservation obs)
|
||
{
|
||
var pobs = (PatientObservation)obs;
|
||
_logger.LogDebug("CalculateRespRate {obsPatientid} wait {obsName} {obsTime} {pobsValue}", obs.PatientId,
|
||
obs.Name, obs.Time, pobs.Value);
|
||
if (Convert.ToDouble(pobs.Value) == 0) return;
|
||
|
||
if (Convert.ToDouble(pobs.Value) == 0) return;
|
||
|
||
var insert = true;
|
||
if (obs.Name == "FR")
|
||
{
|
||
// Insertamos si no existe una obs Vent_Rate o si es existe tiene más de X" y su valor es > 0
|
||
var lastVentRate =
|
||
(await _observationService.Value.FindLastObservations(obs.PatientId, 1, ["Vent_Rate"]))
|
||
.FirstOrDefault();
|
||
if (lastVentRate == null || (double.TryParse(lastVentRate.Value.ToString(), out var v) ? v : 0) == 0)
|
||
{
|
||
_logger.LogDebug("CalculateRespRate {id} lastVentRate: null", obs.PatientId);
|
||
}
|
||
else
|
||
{
|
||
var diff = DateTime.UtcNow.Subtract(lastVentRate.Time.ToUniversalTime());
|
||
insert =
|
||
lastVentRate.Time.ToUniversalTime().AddMinutes(_apiSettings.Value.CalculateRespRateVentExpires) <
|
||
DateTime.UtcNow;
|
||
_logger.LogDebug(
|
||
"CalculateRespRate {patientid} lastVentRate: {value} - {time} passed {diff} {insert}",
|
||
obs.PatientId, lastVentRate.Value, lastVentRate.Time, diff, insert ? "Inserted" : "Not inserted");
|
||
}
|
||
}
|
||
|
||
if (insert)
|
||
{
|
||
_logger.LogDebug(
|
||
"CalculateRespRate {patientid} Insert Resp_Rate_Calculated with {name} - {time} value {value}",
|
||
obs.PatientId, obs.Name, obs.Time, pobs.Value);
|
||
var calculatedRespRate = new PatientObservation
|
||
{
|
||
Id = new ObjectId(),
|
||
Name = "Resp_Rate_Calculated",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = obs.Name == "FR" ? obs.Time : obs.Time.AddSeconds(1),
|
||
Value = pobs.Value,
|
||
ParentData = new ParentDataClass { Name = obs.Name }
|
||
};
|
||
await _observationService.Value.InsertObservation(calculatedRespRate);
|
||
}
|
||
else
|
||
{
|
||
_logger.LogDebug(
|
||
"CalculateRespRate {patientid} Insert Resp_Rate_Calculated with {name} - {time} value {value}",
|
||
obs.PatientId, obs.Name, obs.Time, pobs.Value);
|
||
}
|
||
|
||
_logger.LogDebug("CalculateRespRate {patientid} release {name} {time} {value}", obs.PatientId,
|
||
obs.Name, obs.Time, pobs.Value);
|
||
}
|
||
|
||
/// <summary>
|
||
/// Shifts the timestamp of a <c>Hydric_Balance</c> observation forward by one second when another
|
||
/// <c>Hydric_Balance</c> observation was already recorded within the same hour, so the most
|
||
/// recent entry can be identified unambiguously.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation expected to be a <see cref="PatientObservation"/> with <c>Name</c> <c>Hydric_Balance</c>.</param>
|
||
/// <returns>A task that resolves to the (possibly time-shifted) base patient observation.</returns>
|
||
private async Task<BasePatientObservation> CalculateHydricBalance(BasePatientObservation obs)
|
||
{
|
||
var pobs = (PatientObservation)obs;
|
||
|
||
var lastHydricBalanceFromHour =
|
||
await _observationService.Value.FindLastBeforeDate(pobs.PatientId, pobs.Time.AddMinutes(59),
|
||
"Hydric_Balance");
|
||
|
||
if (lastHydricBalanceFromHour != null &&
|
||
DateTime.Compare(new DateTime(lastHydricBalanceFromHour.Time.Year, lastHydricBalanceFromHour.Time.Month,
|
||
lastHydricBalanceFromHour.Time.Day, lastHydricBalanceFromHour.Time.Hour, 0, 0)
|
||
, new DateTime(pobs.Time.Year, pobs.Time.Month, pobs.Time.Day, pobs.Time.Hour, 0, 0)) == 0)
|
||
pobs.Time = lastHydricBalanceFromHour.Time.AddSeconds(1);
|
||
|
||
return obs;
|
||
}
|
||
|
||
/// <summary>
|
||
/// Shifts the timestamp of a <c>Hour_Balance</c> observation forward by one second when another
|
||
/// <c>Hour_Balance</c> observation was already recorded within the same hour.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation expected to be a <see cref="PatientObservation"/> with <c>Name</c> <c>Hour_Balance</c>.</param>
|
||
/// <returns>A task that resolves to the (possibly time-shifted) base patient observation.</returns>
|
||
private async Task<BasePatientObservation> CalculateHourBalance(BasePatientObservation obs)
|
||
{
|
||
var pobs = (PatientObservation)obs;
|
||
|
||
var lastHourBalanceFromHour =
|
||
await _observationService.Value.FindLastBeforeDate(pobs.PatientId, pobs.Time.AddMinutes(59),
|
||
"Hour_Balance");
|
||
|
||
if (lastHourBalanceFromHour != null &&
|
||
DateTime.Compare(new DateTime(lastHourBalanceFromHour.Time.Year, lastHourBalanceFromHour.Time.Month,
|
||
lastHourBalanceFromHour.Time.Day, lastHourBalanceFromHour.Time.Hour, 0, 0)
|
||
, new DateTime(pobs.Time.Year, pobs.Time.Month, pobs.Time.Day, pobs.Time.Hour, 0, 0)) == 0)
|
||
pobs.Time = lastHourBalanceFromHour.Time.AddSeconds(1);
|
||
|
||
return obs;
|
||
}
|
||
|
||
/// <summary>
|
||
/// Persists a <c>Hydric_Balance_Calculated</c> observation mirroring the supplied
|
||
/// <c>Hydric_Balance</c> value, after enforcing three guards: the observation's hour must not be
|
||
/// in the future, the latest <c>Hydric_Balance_Calculated</c> for the current hour prevents
|
||
/// replaying older hours, and a newer stored <c>Hydric_Balance_Calculated</c> prevents
|
||
/// overwriting it. The stored time is shifted one second forward when an existing calculated
|
||
/// observation in the same hour is detected.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation, expected to be a <see cref="PatientObservation"/> with <c>Name</c> <c>Hydric_Balance</c>.</param>
|
||
/// <returns>A task that represents the asynchronous insert operation.</returns>
|
||
private async Task CalculateHydricBalanceCalculated(BasePatientObservation obs)
|
||
{
|
||
//Hydric_Balance_Calculated
|
||
//No guardamos como calculadas nunca horas futuras. En el obx siempre vienen con la hora y los minutos a 00
|
||
|
||
|
||
var pobs = (PatientObservation)obs;
|
||
var nowUniversalTime = DateTime.Now.ToUniversalTime();
|
||
//La hora de la observación es mayor que la actual. No generamos la calculada
|
||
if (DateTime.Compare(new DateTime(obs.Time.Year, obs.Time.Month, obs.Time.Day, obs.Time.Hour, 0, 0),
|
||
new DateTime(nowUniversalTime.Year, nowUniversalTime.Month, nowUniversalTime.Day, nowUniversalTime.Hour,
|
||
0, 0)) > 0
|
||
)
|
||
{
|
||
_logger.LogDebug(
|
||
"HYDRIC BALANCE: La hora de la observación es mayor que la actual. No generamos la calculada {obs}",
|
||
obs);
|
||
return;
|
||
}
|
||
|
||
//Para la calculada. Si la última que tenemos es de la hora actual y lo que viene es de una hora anterior no entra como calculada.
|
||
var lastHydricBalanceList = await _observationService.Value.FindLastObservations(obs.PatientId, 1,
|
||
["Hydric_Balance_Calculated"]);
|
||
var lastHydricBalance = lastHydricBalanceList.FirstOrDefault();
|
||
|
||
if (lastHydricBalance != null && lastHydricBalance.Time.Hour == DateTime.UtcNow.Hour &&
|
||
obs.Time.Hour != DateTime.UtcNow.Hour)
|
||
{
|
||
_logger.LogDebug(
|
||
"HYDRIC BALANCE: ultima que tenemos es de la hora actual y lo que viene es de una hora anterior no entra como calculada {obs}",
|
||
obs);
|
||
return;
|
||
}
|
||
|
||
//Si el último hydric balance es de una hora posterior a la observación que acaba de llegar no entra como calculada.
|
||
if (lastHydricBalance != null &&
|
||
DateTime.Compare(new DateTime(lastHydricBalance.Time.Year, lastHydricBalance.Time.Month,
|
||
lastHydricBalance.Time.Day, lastHydricBalance.Time.Hour, 0, 0)
|
||
, new DateTime(pobs.Time.Year, pobs.Time.Month, pobs.Time.Day, pobs.Time.Hour, 0, 0)) == 1
|
||
)
|
||
{
|
||
_logger.LogDebug(
|
||
"HYDRIC BALANCE: Si el ultimo hydric balance es de una hora posterior a la observación que acaba de llegar no entra como calculada. {obs}",
|
||
obs);
|
||
return;
|
||
}
|
||
|
||
var calculatedHydricBalance = new PatientObservation
|
||
{
|
||
Name = "Hydric_Balance_Calculated",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = obs.Time.AddSeconds(1), //To discriminate updates.
|
||
Value = pobs.Value,
|
||
Units = obs.Units
|
||
};
|
||
|
||
|
||
if (lastHydricBalance != null && DateTime.Compare(
|
||
new DateTime(lastHydricBalance.Time.Year, lastHydricBalance.Time.Month, lastHydricBalance.Time.Day,
|
||
lastHydricBalance.Time.Hour, 0, 0)
|
||
, new DateTime(pobs.Time.Year, pobs.Time.Month, pobs.Time.Day, pobs.Time.Hour, 0, 0)) == 0)
|
||
calculatedHydricBalance.Time = lastHydricBalance.Time.AddSeconds(1);
|
||
|
||
await _observationService.Value.InsertObservation(calculatedHydricBalance);
|
||
}
|
||
|
||
/// <summary>
|
||
/// Maps a <c>Resp_Mode</c> observation to a <c>Resp_Type</c> value: codes listed in
|
||
/// <c>InvasiveVentilation</c> yield <c>Invasive</c>, otherwise the observation's value is matched
|
||
/// against the configured high-frequency / non-invasive catalogues (yielding
|
||
/// <c>HighFrequencyVentilation</c>, <c>NonInvasive</c>, or <c>Invasive</c> as fallback). Values
|
||
/// equal to <c>"EnESPERA"</c> are skipped.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation, expected to be a <see cref="PatientObservation"/> with <c>Name</c> <c>Resp_Mode</c>.</param>
|
||
/// <returns>A task that represents the asynchronous insert operation.</returns>
|
||
private async Task CalculateVentilationMode(BasePatientObservation obs)
|
||
{
|
||
_logger.LogDebug("CalculateVentilationMode {obs}", obs);
|
||
var pobs = (PatientObservation)obs;
|
||
|
||
var respTypeObs = new PatientObservation
|
||
{
|
||
Name = "Resp_Type",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = obs.Time
|
||
};
|
||
//https://epigram.teamwork.com/#/tasks/34765750
|
||
if (obs.Code != null && _codesForInvasiveVentilation.Contains(obs.Code))
|
||
{
|
||
//añadir que sea solo cuando el valor es invasiva
|
||
respTypeObs.Value = nameof(RespirationType.Invasive);
|
||
respTypeObs.Time = obs.Time.AddSeconds(1);
|
||
await _observationService.Value.InsertIfChanged("Resp_Type", respTypeObs);
|
||
}
|
||
else
|
||
{
|
||
var strValue = pobs.Value.ToString();
|
||
if (strValue == null)
|
||
return;
|
||
|
||
//si es en espera tendrá que insertar que es en espera
|
||
if (!"EnESPERA".Equals(strValue))
|
||
{
|
||
respTypeObs.Value = _highFrequencyVentilation.Contains(strValue)
|
||
? nameof(RespirationType.HighFrequencyVentilation)
|
||
: _nonInvasiveVentilation.Contains(strValue)
|
||
? respTypeObs.Value = nameof(RespirationType.NonInvasive)
|
||
: nameof(RespirationType.Invasive);
|
||
|
||
await _observationService.Value.InsertIfChanged("Resp_Type", respTypeObs);
|
||
}
|
||
}
|
||
}
|
||
|
||
/// <summary>
|
||
/// Computes the <c>Weight_Diff</c> observation (new weight − previous weight, rounded to two
|
||
/// decimals) by comparing the supplied <c>Weight_Current</c> observation against the most
|
||
/// recently stored one for the same patient. Skipped when either value cannot be parsed.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation, expected to be a <see cref="PatientObservation"/> with <c>Name</c> <c>Weight_Current</c>.</param>
|
||
/// <returns>A task that represents the asynchronous insert operation.</returns>
|
||
private async Task CalculateWeight_DiffObservation(BasePatientObservation obs)
|
||
{
|
||
var toSearchList = new List<string>();
|
||
|
||
toSearchList.AddRange(new List<string> { "Weight_Current" });
|
||
|
||
var values = await _observationService.Value.FindLastObservations(obs.PatientId, 1, toSearchList);
|
||
|
||
var pWeight = values.FirstOrDefault(o => o.Name == "Weight_Current");
|
||
|
||
var newWeightObs = (PatientObservation)obs;
|
||
|
||
if (pWeight?.Value != null && double.TryParse(pWeight.Value.ToString(), out var weight) &&
|
||
double.TryParse(newWeightObs.Value.ToString(), out var newWeight))
|
||
{
|
||
var weightDiffValue = Math.Round(newWeight - weight, 2);
|
||
|
||
var weightDiff = new PatientObservation
|
||
{
|
||
Name = "Weight_Diff",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = obs.Time,
|
||
Value = weightDiffValue,
|
||
Units = obs.Units
|
||
};
|
||
|
||
await _observationService.Value.InsertObservation(weightDiff);
|
||
}
|
||
}
|
||
|
||
/// <summary>
|
||
/// Computes the <c>Diuresis_Weight</c> observation (diuresis / current weight in ml/kg) when
|
||
/// either a <c>Diuresis</c> or a <c>Weight_Current</c> observation is received. When triggered
|
||
/// by <c>Weight_Current</c>, the operation is skipped if the latest <c>Diuresis</c> observation
|
||
/// has expired. Skipped silently when the weight is zero or any value is unparsable.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation (<c>Diuresis</c> or <c>Weight_Current</c>).</param>
|
||
/// <returns>A task that represents the asynchronous insert operation.</returns>
|
||
private async Task CalculateDiureis_WeightObservation(BasePatientObservation obs)
|
||
{
|
||
var toSearchList = new List<string>();
|
||
|
||
PatientObservation? diuresisObs;
|
||
PatientObservation? weightObs;
|
||
|
||
toSearchList.AddRange(new List<string> { "Diuresis", "Weight_Current" });
|
||
|
||
var values = await _observationService.Value.FindLastObservations(obs.PatientId, 1, toSearchList);
|
||
|
||
if (obs.Name == "Diuresis")
|
||
{
|
||
diuresisObs = (PatientObservation)obs;
|
||
weightObs = values.FirstOrDefault(o => o.Name == "Weight_Current");
|
||
}
|
||
else
|
||
{
|
||
weightObs = (PatientObservation)obs;
|
||
diuresisObs = values.FirstOrDefault(o => o.Name == "Diuresis");
|
||
|
||
if (diuresisObs == null || CheckExpired(diuresisObs)) return;
|
||
}
|
||
|
||
if (weightObs?.Value != null)
|
||
if (double.TryParse(weightObs.Value.ToString(), out var nWeight) && nWeight != 0 &&
|
||
double.TryParse(diuresisObs.Value.ToString(), out var diuresis))
|
||
{
|
||
var diruesisWeightValue = Math.Round(diuresis / nWeight, 2);
|
||
|
||
var diruesisWeight = new PatientObservation
|
||
{
|
||
Name = "Diuresis_Weight",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = obs.Time,
|
||
Value = diruesisWeightValue,
|
||
Units = "ml/kg"
|
||
};
|
||
|
||
await _observationService.Value.InsertObservation(diruesisWeight);
|
||
}
|
||
}
|
||
|
||
/// <summary>
|
||
/// Aggregates a <c>AllergiesObs</c> observation into a single <c>Allergies</c> string per type,
|
||
/// special-casing drug allergies ("FÁRMACOS") into a single grouped entry and setting the
|
||
/// <c>Status</c> to <c>Alert</c> when drug allergies are present. <c>InvalidCastException</c>s
|
||
/// are logged and swallowed.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation, expected to be a <see cref="PatientObservation"/> with <c>Name</c> <c>AllergiesObs</c> and a collection-valued <c>Value</c> of <see cref="PatientAllergiesValue"/>.</param>
|
||
/// <returns>A task that represents the asynchronous insert operation.</returns>
|
||
private async Task CalculateAllergiesObservation(BasePatientObservation obs)
|
||
{
|
||
try
|
||
{
|
||
var pobs = (PatientObservation)obs;
|
||
|
||
var allergiesObs = new PatientObservation
|
||
{
|
||
Name = "Allergies",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = obs.Time,
|
||
MessageTime = pobs.MessageTime
|
||
};
|
||
|
||
var patientAllergiesValues =
|
||
new List<PatientAllergiesValue>((IEnumerable<PatientAllergiesValue>)pobs.Value);
|
||
|
||
var allergiesValues = patientAllergiesValues.GroupBy(o => o.Type)
|
||
.Select(x =>
|
||
new PatientAllergiesValue
|
||
{
|
||
Type = x.Key,
|
||
Value = string.Join(", ", x.Select(v => v.Value)),
|
||
Notes = string.Join(", ", x.Select(n => n.Notes))
|
||
}).ToList();
|
||
|
||
|
||
var farmacosType = false;
|
||
var farmacosValues = new List<string>();
|
||
var values = new List<string>();
|
||
|
||
foreach (var allergies in allergiesValues)
|
||
{
|
||
if (allergies.Value == null)
|
||
continue;
|
||
|
||
var type = allergies.Type?.Replace("Alergia a ", "").Replace("Alergia ", "").ToUpper();
|
||
|
||
if (type != null)
|
||
switch (type)
|
||
{
|
||
case "FÁRMACOS":
|
||
farmacosType = true;
|
||
farmacosValues.Add(allergies.Value.ToUpper());
|
||
break;
|
||
|
||
default:
|
||
values.Add(type);
|
||
break;
|
||
}
|
||
}
|
||
|
||
if (farmacosType)
|
||
{
|
||
values.Add($"FÁRMACOS ({string.Join(", ", farmacosValues)})");
|
||
allergiesObs.Status = StatusEnum.Type.Alert;
|
||
}
|
||
|
||
allergiesObs.Value = string.Join(", ", values);
|
||
|
||
await _observationService.Value.InsertObservation(allergiesObs);
|
||
}
|
||
catch (InvalidCastException)
|
||
{
|
||
_logger.LogError("CalculateAllergiesObservation {obs}", obs);
|
||
}
|
||
}
|
||
|
||
/// <summary>
|
||
/// For a <c>DrainagesObs</c> observation of type <c>"Drenaje ventricular"</c>, persists the
|
||
/// derived <c>DVE</c> (volume) and <c>Drainage_Height</c> observations using the underlying
|
||
/// <see cref="PatientDrainagesValue"/> properties.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation, expected to be a <see cref="PatientObservation"/> with <c>Name</c> <c>DrainagesObs</c> and a <see cref="PatientDrainagesValue"/>-typed <c>Value</c>.</param>
|
||
/// <returns>A task that represents the asynchronous insert operation.</returns>
|
||
private async Task CalculateDrainagesObservation(BasePatientObservation obs)
|
||
{
|
||
var pobs = (PatientObservation)obs;
|
||
|
||
var patientDraingesValue = (PatientDrainagesValue)pobs.Value;
|
||
|
||
if (patientDraingesValue.Type == "Drenaje ventricular")
|
||
{
|
||
var dve = new PatientObservation
|
||
{
|
||
Name = "DVE",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = obs.Time,
|
||
Units = obs.Units
|
||
};
|
||
|
||
var drainageHeight = new PatientObservation
|
||
{
|
||
Name = "Drainage_Height",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = obs.Time
|
||
};
|
||
|
||
if (patientDraingesValue.Volume != null)
|
||
{
|
||
dve.Value = patientDraingesValue.Volume;
|
||
await _observationService.Value.InsertObservation(dve);
|
||
}
|
||
|
||
if (patientDraingesValue.Height != null)
|
||
{
|
||
drainageHeight.Value = patientDraingesValue.Height;
|
||
await _observationService.Value.InsertObservation(drainageHeight);
|
||
}
|
||
}
|
||
}
|
||
|
||
/// <summary>
|
||
/// Computes the <c>Delta_Pressure</c> observation (driving pressure = plateau − PEEP) when both
|
||
/// <c>PEEP</c> and <c>Pleateu_Pressure</c> observations are available. The stored <c>Time</c> is
|
||
/// the most recent of the two source observations, so the result is anchored to the latest input.
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation (<c>PEEP</c> or <c>Pleateu_Pressure</c>).</param>
|
||
/// <returns>A task that represents the asynchronous insert operation.</returns>
|
||
private async Task CalculateDelta_PressureObservation(BasePatientObservation obs)
|
||
{
|
||
var toSearchList = new List<string>();
|
||
|
||
PatientObservation? peep;
|
||
PatientObservation? pleateuPressure;
|
||
|
||
toSearchList.AddRange(new List<string> { "PEEP", "Pleateu_Pressure" });
|
||
|
||
var values = await _observationService.Value.FindLastObservations(obs.PatientId, 1, toSearchList);
|
||
var time = obs.Time;
|
||
double pleateuPressureValue = 0;
|
||
|
||
if (obs.Name == "PEEP")
|
||
{
|
||
peep = (PatientObservation)obs;
|
||
pleateuPressure = values.FirstOrDefault(o => o.Name == "Pleateu_Pressure");
|
||
|
||
if (pleateuPressure?.Time != null && time.CompareTo(pleateuPressure.Time) > 0) time = pleateuPressure.Time;
|
||
}
|
||
else
|
||
{
|
||
pleateuPressure = (PatientObservation)obs;
|
||
peep = values.FirstOrDefault(o => o.Name == "PEEP");
|
||
|
||
if (peep?.Time != null && time.CompareTo(peep.Time) > 0) time = peep.Time;
|
||
}
|
||
|
||
if (peep?.Value != null && pleateuPressure?.Value != null)
|
||
{
|
||
var peepSuccess = double.TryParse(peep.Value.ToString(), out var peepValue);
|
||
if (!peepSuccess) peepValue = 0;
|
||
|
||
if (!peepSuccess) pleateuPressureValue = 0;
|
||
|
||
var deltaPressure = Math.Round(pleateuPressureValue - peepValue, 2);
|
||
|
||
|
||
var deltaPressureObs = new PatientObservation
|
||
{
|
||
Name = "Delta_Pressure",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = time,
|
||
Value = deltaPressure
|
||
};
|
||
|
||
await _observationService.Value.InsertObservation(deltaPressureObs);
|
||
}
|
||
}
|
||
|
||
/// <summary>
|
||
/// Persists a <c>Daily_Balance_Calculated</c> observation mirroring the supplied
|
||
/// <c>Daily_Balance</c> value, but only when the local hour of the observation is 8 (the daily
|
||
/// balance cut-off used by the HRYC customization).
|
||
/// </summary>
|
||
/// <param name="obs">The base patient observation that triggered the calculation, expected to be a <see cref="PatientObservation"/> with <c>Name</c> <c>Daily_Balance</c>.</param>
|
||
/// <returns>A task that represents the asynchronous insert operation.</returns>
|
||
private async Task CalculateDaily_BalanceObservation(BasePatientObservation obs)
|
||
{
|
||
if (obs.Time.ToLocalTime().Hour == 8)
|
||
{
|
||
var dailyBalanceCalculated = new PatientObservation
|
||
{
|
||
Name = "Daily_Balance_Calculated",
|
||
CodingSystem = "ADAS",
|
||
PatientId = obs.PatientId,
|
||
Time = DateTime.Now,
|
||
Units = obs.Units,
|
||
Value = ((PatientObservation)obs).Value
|
||
};
|
||
|
||
await _observationService.Value.InsertObservation(dailyBalanceCalculated);
|
||
}
|
||
}
|
||
|
||
/// <summary>
|
||
/// Determines whether a patient observation has expired by comparing the current time against
|
||
/// <c>Time + Expires</c> seconds, when <c>Expires</c> is set.
|
||
/// </summary>
|
||
/// <param name="obs">The patient observation to evaluate.</param>
|
||
/// <returns>
|
||
/// <see langword="true"/> when the observation has an <c>Expires</c> value and the current time
|
||
/// is past the expiration instant; otherwise, <see langword="false"/>.
|
||
/// </returns>
|
||
private static bool CheckExpired(PatientObservation obs)
|
||
{
|
||
if (obs.Expires == null) return false;
|
||
|
||
var timeExpire = obs.Time.ToLocalTime().AddSeconds(Convert.ToDouble(obs.Expires));
|
||
|
||
return DateTime.Now.CompareTo(timeExpire) > 0;
|
||
}
|
||
} |