Pediatric platform draft

LOSPOR_PEDIATRICS v1 is an inactive, source-backed platform draft. It is not published, selected, or available for clinical use. Its purpose is to put the whole pediatric catalog into the normal ruleset hierarchy for structured review, without turning unresolved evidence into selector defaults.

Download the exact generated artifacts:

• Pediatric v1 draft (JSON)
• Adult v2 metadata draft (JSON)

The source of truth is lospor-core/src/platform-clinical-drafts.ts. The JSON files are deterministic review exports; they are not database backups.

Pediatric v1 contents

Rule type	Count	Runtime effect
Drug policy ledger	181	None
Drug profiles	3	Selector surface, only after publication
Equipment policy ledger	28	None
Equipment suggestions	41	Suggestion field, only after publication
Total	253	Draft only

Every one of the 181 canonical intraoperative drugs has exactly one editable policy row. Policy rows record a disposition, review status, rationale, and source references. The runtime ignores them. Only a PEDIATRIC_DRUG_PROFILE can supply a route, dose, slider, concentration, formulation, or pill.

Drug disposition ledger

Disposition	Count
AUTOFILL_PROFILE	2
MANUAL_NO_PROFILE	47
FORMULARY_REQUIRED	51
SCHEMA_BLOCKED	18
EXCLUDED	35
PENDING_RESEARCH	28

Review state is deliberately separate from disposition: 61 rows are evidence reviewed, 51 require a local formulary decision, and 69 remain pending. An evidence-reviewed row is not equivalent to clinical approval.

All 40 antimicrobials are FORMULARY_REQUIRED. Route alone cannot distinguish prophylaxis from treatment or retain procedure/site, local resistance, gestation, renal, infusion, redosing, and monitoring constraints. Institutions can add them only through a locally governed antimicrobial protocol. The class policy follows Children's Health Queensland pediatric surgical prophylaxis, NICE NG125, and UKHSA Start Smart—Then Focus.

Executable pediatric drug candidates

These remain inactive and unapproved. They are the only reviewed candidates that the current route-only selector can represent without discarding a critical constraint.

Drug	Age band	Routes	Draft autofill	Concentration
Ondansetron	1 month to under 18 years	IV	0.1 mg/kg TBW, round 0.1 mg, cap 4 mg	2 mg/mL
Chlorphenamine	1 month to under 1 year	IV, IM, SC	0.25 mg/kg TBW, round 0.1 mg	1 mg/mL default; 10 mg/mL stock
Chlorphenamine	1 year to under 18 years	IV, IM, SC	0.20 mg/kg TBW, round 0.1 mg	10 mg/mL

The chlorphenamine 20 mg slider ceiling is a user-interface range, not a calculated dose cap. The source is the current chlorphenamine injection SmPC. Ondansetron is scoped to perioperative PONV and follows the ondansetron SmPC; the same IV route must not be generalized to chemotherapy regimens.

No fixed pediatric quick-dose pills were inferred. The selector supports them, but a platform pill needs its own defensible total-dose value. A calculated weight-based suggestion is not duplicated as a pill.

Etomidate and rectal methohexital are explicitly schema-blocked. Their labels use strict “older than” age boundaries that the inclusive lower-age field cannot encode exactly; methohexital also has no source-backed finite total slider ceiling. They were not approximated with hidden epsilon values or invented caps.

Pediatric local anesthetics remain schema-blocked. Concentration, preparation or baricity, route/site, weight-based maximum, adjuncts, and cumulative dose must remain linked. The current independent concentration and formulation pills cannot express that preparation matrix safely.

Equipment draft

The 41 equipment rules are suggestions only. They never select or prefill a device. The draft includes product-specific weight bands for Teleflex LMA Unique, Intersurgical i-gel, Laerdal Silicone Resuscitator, and Arrow EZ-IO; anaesthesia-circuit preparation; ETT and blade preparation; OPA/NPA references; suction, peripheral IV and BP-cuff manual selection; and RCUK AED mode/pad placement without duplicating defibrillation energy.

Formula- or measurement-dependent choices remain explicit policy rows. These include ETT type/size/depth, suction catheter from actual ETT ID, BP cuff from mid-arm circumference, generic SGA/BVM/IO tables, and delivery-room NLS equipment. The canonical LOSPOR resuscitation calculator remains the only source of defibrillation energy.

Primary equipment sources include the APAGBI beginner guide, RCoA GPAS Chapter 10, RCUK 2025 pediatric BLS, and the exact manufacturer documents stored on each product rule.

Adult v2 draft

Adult v2 is a full 252-rule snapshot, not a delta overlay. It preserves the existing 181 drugs, 48 infusions, 22 fluids, and adult equipment policy. Eight local-anesthetic profiles add explicit PERCENT concentration units and route defaults. Safely representable neuraxial formulation pills are added for:

• lidocaine 5% hyperbaric;
• bupivacaine 0.5% isobaric or hyperbaric (hyperbaric default);
• prilocaine 2% hyperbaric;
• chloroprocaine 1% isobaric; and
• tetracaine 1% isobaric.

No platform hypobaric preparation is inferred. Ropivacaine and mepivacaine retain the route surface but have no intrathecal concentration or formulation pill. Levobupivacaine receives no baricity pill because the cited product information does not identify one.

Editing and publication

The web clinical-rules workbench edits both executable rules and the new policy rows. The normal hierarchy remains unchanged:

1. a platform administrator governs platform rulesets;
2. an institution copies a ruleset and publishes its own complete version; and
3. a member copies an accessible ruleset and publishes a personal version.

The first selected published ruleset in personal → institution → platform order wins. Levels are not merged, and Pediatric never falls back to Adult.

Publication validation blocks a pediatric draft while any policy is not APPROVED, while any drug/equipment remains PENDING_RESEARCH, or when a policy claims an executable profile/suggestion that is absent. The importer is append-only and aborts on an identity collision. It never updates, deletes, publishes, or selects a ruleset.