⚕ ENKI-CLINICAL Suite
Fluid & Transfusion Engine

FTE™ — Perioperative Clinical
Decision Tool

IV fluid planning · Blood product guidance · Allowable blood loss · Massive hemorrhage protocol support. Doctrine-compliant. Fully offline. Installs as a PWA.

Dr. Amir Fadhel
Dr. Amir Fadhel
MBChB, FICMS-AIC
Specialist — Anesthesiology & Critical Care
🇮🇶 Wasit Governorate, Iraq
100%
Offline Ready
v1.5
Current Build
PWA
Installable
0
Invented Thresholds
Core Capabilities

What FTE™ Provides

A complete perioperative fluid and transfusion decision support tool built for anesthesiologists, surgeons, and critical care teams.

💧

IV Fluid Planning

Maintenance rate (4-2-1 rule), fasting deficit, 50/25/25 replacement schedule, and hourly surgical loss by case classification. Full per-hour timeline view.

🩸

Blood Product Guidance

PRBC, FFP, platelet, and cryoprecipitate dosing based on labs and configured trigger targets. Transfusion threshold is user-set — not hardcoded.

⚖️

Allowable Blood Loss

ABL calculated by Hb or Hct method from EBV and configured target. Live remaining ABL tracked as EBL accumulates during the OR session.

🚨

Massive Hemorrhage Protocol

Configurable MHP triggers. WB and PRBC+FFP cycle templates. One-tap MHP activation with real-time product cycle tracking in OR dashboard.

📱

Offline PWA

Install as a mobile or desktop app. Service worker precaches all assets. Works in the OR with no internet connection — no login server required.

🔐

Secure Local Profile

WebCrypto SHA-256 PIN with unique salt per user. Brute-force lockout ladder (30s → 2min → 10min). Data stored on-device only — nothing transmitted.

🗂️

Case Logging & Export

Save and review cases. Export as JSON or RFC 4180-compliant CSV. Full case summary generation for documentation and shift handover.

👶

Pediatric & Obstetric

Age-adjusted EBV from neonate through adult. Obstetric physiologic profile with PPH risk flags. Age-group-specific blood product dosing logic.

🌙

Day / Night Mode

Toggle between dark clinical and day themes. Designed for extended operative sessions — low glare on night call, readable in bright procedure rooms.

Doctrine-Compliant

The Clinical Engine

Every calculation maps to explicit medical doctrine. No invented thresholds. Every configurable value is clearly labeled and user-controlled.

Fluid Engine

  • Maintenance (4-2-1):  4 mL/kg/hr first 10 kg · 2 mL/kg/hr next 10 kg · 1 mL/kg/hr above 20 kg
  • Fasting Deficit:  Maintenance rate × NPO hours
  • Deficit Distribution:  50% in Hour 1 · 25% in Hour 2 · 25% in Hour 3 · 0% from Hour 4 onward
  • Surgical Loss Bands:  Minor 2–4 mL/kg/hr · Moderate 4–6 · Major 8–10 mL/kg/hr (default midpoints)
  • Hourly Total:  Deficit share + surgical loss rate + maintenance
H₁ = (Fasting Deficit × 0.50) + Surgical Loss + Maintenance
H₂ = (Fasting Deficit × 0.25) + Surgical Loss + Maintenance

Blood Engine

  • EBV:  Weight × coefficient (mL/kg) — age, sex, and physiologic profile adjusted
  • ABL — Hb method:  EBV × (Hb_initial − Hb_target) ÷ Hb_average
  • ABL — Hct method:  EBV × (Hct_initial − Hct_target) ÷ Hct_average
  • Transfusion trigger:  User-configured in Settings — never hardcoded
  • PRBC (adult):  1 unit ≈ +1 g/dL Hb rise
  • FFP:  10–15 mL/kg — INR-guided
  • Cryoprecipitate:  fibrinogen-guided
  • Platelets:  count-guided

Lab Validation

  • Hb 1–25 g/dL · Hct 1–70% · INR 0.7–10 · Platelets 1–1000 ×10⁹/L · Fibrinogen 0.1–10 g/L
  • Out-of-range values are flagged with a warning modal and excluded — they never silently drive recommendations

Comorbidity Modifiers

  • CHF, CKD, IHD, Neurologic, and Obstetric flags modify fluid warnings, alert thresholds, and EBV coefficients
  • No modifier introduces invented thresholds — all adjustments reference established physiologic principles
Live Session Module

OR Dashboard

Real-time intraoperative tracking — timer, fluid logging, EBL accumulation, MHP activation, and end-of-case summary generation.

⏱️

Live OR Timer

Start/stop session clock. Elapsed time in sticky patient bar alongside name, MRN, and case date.

📋

Intraop Fluid Log

Log crystalloid, colloid, blood products, EBL, and urine output in real time. Cumulative totals update instantly.

📊

ABL Tracking

Remaining allowable blood loss recalculated as EBL accumulates. Trigger alert fires when Hb approaches threshold.

🚨

MHP Activation

One-tap massive hemorrhage protocol. Cycle counter, product ratio display, and real-time MHP status.

⚠️

Vitals Flags

Pre-induction vitals entry — HR, SBP, SpO₂, Temp, Lactate. Hemodynamic flags fire on out-of-range values.

📄

Case Summary

Auto-generated case summary with all logged events. Exportable plain text for documentation and handover.

Licensing

Pricing

Single-user PWA license available now. Hospital edition available under direct request only.

🆓 Free Trial
FTE™ Trial
7-Day Access
FREE
 
Full Access · No Card Required
  • Complete fluid & transfusion engine
  • OR dashboard with live timer
  • ABL & MHP protocol support
  • Case logging & export
  • Pediatric & obstetric profiles
  • No payment or registration required
Start Free Trial ↗
🏗 Coming Soon
MSI Hospital Edition
Institutional License
$150
200,000 IQD
Per Year · Multi-Seat Institutional

Hospital-grade deployment with institutional licensing, admin panel, and multi-user support.

Available under direct request only.
Contact Dr. Amir Fadhel for deployment timeline and institutional quote.

  • Everything in Personal PWA
  • Multi-seat institutional deployment
  • Admin licensing dashboard
  • Hospital branding configuration
  • Dedicated onboarding & support
  • Priority feature requests
Request Information

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Licensing & Inquiries

Contact Dr. Amir Fadhel

Direct contact for PWA licensing and MSI Hospital Edition requests.

💳 PayPal · Qi Card · Visa / MasterCard · Bank Transfer available

Response within 24 hours · All inquiries confidential

Payment Methods Accepted

💳 Qi Card (Iraq)
💳 Visa / MasterCard
💰 PayPal
🏦 Bank Transfer
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