const pptxgen = require("pptxgenjs");

let pres = new pptxgen();
pres.layout = 'LAYOUT_16x9';
pres.title = 'Trauma Management & Indian Road Accident Data';

// ─── THEME COLORS ───
const DARK_BG   = "1A2340";   // deep navy
const MID_BG    = "243058";   // slightly lighter navy
const ACCENT    = "E84B3C";   // emergency red
const ACCENT2   = "F5A623";   // amber
const WHITE     = "FFFFFF";
const LIGHT     = "D8E0F0";
const GRAY      = "8A97B0";

// ─── HELPER: slide background ───
function darkSlide(pres) {
  let s = pres.addSlide();
  s.background = { color: DARK_BG };
  return s;
}
function midSlide(pres) {
  let s = pres.addSlide();
  s.background = { color: MID_BG };
  return s;
}

// ═══════════════════════════════════════════════════════
// SLIDE 1 – TITLE
// ═══════════════════════════════════════════════════════
{
  let s = darkSlide(pres);
  // Red accent bar left
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 0.18, h: 5.625, fill: { color: ACCENT } });

  // Red accent bar top
  s.addShape(pres.ShapeType.rect, { x: 0.18, y: 0, w: 9.82, h: 0.08, fill: { color: ACCENT } });

  // Main title
  s.addText("TRAUMA MANAGEMENT", {
    x: 0.5, y: 0.8, w: 9, h: 0.85,
    fontSize: 44, bold: true, color: WHITE, fontFace: "Calibri",
    charSpacing: 4
  });
  s.addText("& Indian Road Accident Statistics", {
    x: 0.5, y: 1.65, w: 9, h: 0.55,
    fontSize: 26, color: ACCENT2, fontFace: "Calibri", italic: false
  });

  // Divider
  s.addShape(pres.ShapeType.rect, { x: 0.5, y: 2.3, w: 4.5, h: 0.05, fill: { color: ACCENT } });

  // Subtitle description
  s.addText("Initial Assessment · Hemorrhage Control · Resuscitation\nIndia Road Crash Epidemiology · Prevention", {
    x: 0.5, y: 2.55, w: 9, h: 0.9,
    fontSize: 17, color: LIGHT, fontFace: "Calibri", lineSpacingMultiple: 1.4
  });

  // Source tag
  s.addText("Sources: UpToDate (Jun 2026) · MoRTH 2024 · WHO Global Status Report", {
    x: 0.5, y: 5.1, w: 9.3, h: 0.4,
    fontSize: 11, color: GRAY, fontFace: "Calibri", italic: true
  });
}

// ═══════════════════════════════════════════════════════
// SLIDE 2 – INDIAN ROAD ACCIDENT OVERVIEW (2024)
// ═══════════════════════════════════════════════════════
{
  let s = darkSlide(pres);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.65, fill: { color: ACCENT } });
  s.addText("🇮🇳  INDIA ROAD ACCIDENT CRISIS  —  2024 DATA", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.45,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri", margin: 0
  });

  // STAT BOXES  row 1
  const stats1 = [
    { val: "4.80 L", lbl: "Road Accidents\n(2024)", bg: "8B1A1A" },
    { val: "1.77 L", lbl: "Deaths\n(MoRTH 2024)", bg: "9B2A10" },
    { val: "485", lbl: "Deaths per Day", bg: "7A1E1E" },
    { val: "+2.3%", lbl: "Rise vs 2023", bg: "5A3010" },
  ];
  stats1.forEach((st, i) => {
    let x = 0.25 + i * 2.42;
    s.addShape(pres.ShapeType.roundRect, { x, y: 0.8, w: 2.2, h: 1.35,
      fill: { color: st.bg }, line: { color: ACCENT, width: 1.5 }, rectRadius: 0.08 });
    s.addText(st.val, { x, y: 0.88, w: 2.2, h: 0.7,
      fontSize: 30, bold: true, color: WHITE, align: "center", fontFace: "Calibri" });
    s.addText(st.lbl, { x, y: 1.6, w: 2.2, h: 0.45,
      fontSize: 12, color: ACCENT2, align: "center", fontFace: "Calibri" });
  });

  // Row 2 bullet points
  const bullets = [
    "India ranks #1 worldwide in road deaths — ahead of China and the US (World Road Statistics, IRF)",
    "India accounts for 11% of global road deaths despite having only 1% of the global vehicle population",
    "18-45 age group — 66.1% of all road accident deaths (prime productive age group)",
    "Two-wheelers — 46.2% of deaths  |  Pedestrians — 20.6% of deaths",
    "National Highways (only 2.1% of road network) — 36.6% share in total deaths",
    "Over-speeding responsible for 70.3% of all road crash fatalities",
    "WHO target: 50% reduction in road deaths by 2030 (SDG 3.6) — India far off-track",
  ];

  s.addText(bullets.map((b, i) => ({
    text: b,
    options: { bullet: { type: "bullet", code: "25A0", color: ACCENT },
               color: i === 0 || i === 1 ? ACCENT2 : LIGHT,
               fontSize: 12.5, bold: i < 2, breakLine: true, paraSpaceAfter: 3 }
  })), { x: 0.3, y: 2.28, w: 9.4, h: 3.0, fontFace: "Calibri" });
}

// ═══════════════════════════════════════════════════════
// SLIDE 3 – STATE-WISE & SEVERITY DATA
// ═══════════════════════════════════════════════════════
{
  let s = midSlide(pres);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.65, fill: { color: ACCENT } });
  s.addText("STATE-WISE ROAD ACCIDENT DATA  (2024)", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.45,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri", margin: 0
  });

  // LEFT COLUMN – top states table
  s.addText("Top States by Accidents (2024)", {
    x: 0.3, y: 0.8, w: 4.5, h: 0.38,
    fontSize: 15, bold: true, color: ACCENT2, fontFace: "Calibri"
  });

  const tableRows = [
    [{ text: "State", options: { bold: true, color: ACCENT2 } },
     { text: "Accidents", options: { bold: true, color: ACCENT2 } },
     { text: "Deaths", options: { bold: true, color: ACCENT2 } }],
    ["Uttar Pradesh", "~47,000", "~24,600"],
    ["Tamil Nadu", "~63,000", "~17,000"],
    ["Madhya Pradesh", "~52,000", "~14,800"],
    ["Rajasthan", "~30,000", "~14,200"],
    ["Maharashtra", "~32,000", "~13,500"],
  ];

  s.addTable(tableRows, {
    x: 0.3, y: 1.2, w: 4.5, h: 2.8,
    colW: [2.1, 1.2, 1.2],
    fill: { color: "1E2D50" },
    border: { type: "solid", color: "2D4080", pt: 0.8 },
    fontFace: "Calibri", fontSize: 12.5, color: WHITE,
    align: "center"
  });

  // RIGHT COLUMN – severity
  s.addText("Accident Severity Index", {
    x: 5.1, y: 0.8, w: 4.6, h: 0.38,
    fontSize: 15, bold: true, color: ACCENT2, fontFace: "Calibri"
  });

  const severityData = [
    { state: "Uttar Pradesh", val: "52.4%", note: "Highest — 1 death / 2 accidents", color: ACCENT },
    { state: "Rajasthan", val: "47.5%", note: "Very high severity", color: "D04020" },
    { state: "Gujarat", val: "49.5%", note: "Slight rise from 48%", color: "C04020" },
    { state: "Telangana", val: "30.6%", note: "Best improvement (-2.8%)", color: "4A9040" },
    { state: "Kerala", val: "~7.6%", note: "Lowest — best post-crash care", color: "2A7060" },
  ];

  severityData.forEach((d, i) => {
    let y = 1.2 + i * 0.56;
    s.addShape(pres.ShapeType.roundRect, { x: 5.1, y, w: 4.6, h: 0.5,
      fill: { color: "1A2840" }, line: { color: d.color, width: 1.5 }, rectRadius: 0.06 });
    s.addText(d.state, { x: 5.2, y: y + 0.04, w: 1.6, h: 0.25,
      fontSize: 11.5, bold: true, color: WHITE, fontFace: "Calibri" });
    s.addText(d.val, { x: 6.8, y: y + 0.02, w: 0.9, h: 0.3,
      fontSize: 16, bold: true, color: d.color, fontFace: "Calibri", align: "center" });
    s.addText(d.note, { x: 7.7, y: y + 0.08, w: 1.9, h: 0.3,
      fontSize: 9.5, color: GRAY, fontFace: "Calibri", italic: true });
  });

  // Bottom note
  s.addText("Golden Hour loss: 30-40% of deaths occur within 1 hour of crash (delayed trauma care)  |  Urban-rural enforcement gap persists", {
    x: 0.3, y: 5.1, w: 9.4, h: 0.38,
    fontSize: 10.5, color: GRAY, fontFace: "Calibri", italic: true
  });
}

// ═══════════════════════════════════════════════════════
// SLIDE 4 – TRAUMA EPIDEMIOLOGY
// ═══════════════════════════════════════════════════════
{
  let s = darkSlide(pres);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.65, fill: { color: "4A2010" } });
  s.addText("TRAUMA EPIDEMIOLOGY  —  GLOBAL CONTEXT", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.45,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri", margin: 0
  });

  const items = [
    { icon: "🌍", bold: "Leading cause of mortality globally.", rest: " Worldwide road traffic injuries are the #1 cause of death in ages 18-29." },
    { icon: "🇺🇸", bold: "United States:", rest: " Trauma is the leading cause of death in young adults, accounting for 10% of all deaths among men and women." },
    { icon: "🏥", bold: ">50 million patients/year", rest: " receive trauma-related care in the US alone; ~30% of all ICU admissions are trauma-related." },
    { icon: "⚡", bold: "Hemorrhage is the #1 preventable cause of trauma death.", rest: " ~1/3 of traumatic deaths result from exsanguination; half result from CNS injury." },
    { icon: "⏱️", bold: "Trauma center care:", rest: " Associated with significantly lower morbidity & mortality (10.4% vs 13.8%; RR 0.75)." },
    { icon: "🧠", bold: "Traumatic Brain Injury (TBI)", rest: " is the leading cause of trauma death; hemorrhage is second." },
    { icon: "📉", bold: "WHO 2030 SDG 3.6:", rest: " Halve global road deaths. India needs a 50% reduction — current trajectory is far off-track." },
  ];

  items.forEach((item, i) => {
    let y = 0.8 + i * 0.63;
    s.addText(item.icon, { x: 0.2, y, w: 0.5, h: 0.5, fontSize: 20, align: "center" });
    s.addText([
      { text: item.bold, options: { bold: true, color: ACCENT2 } },
      { text: item.rest, options: { bold: false, color: LIGHT } }
    ], { x: 0.75, y: y + 0.06, w: 9, h: 0.48, fontSize: 13, fontFace: "Calibri" });
  });
}

// ═══════════════════════════════════════════════════════
// SLIDE 5 – CLASSIFICATION OF HEMORRHAGE
// ═══════════════════════════════════════════════════════
{
  let s = darkSlide(pres);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.65, fill: { color: ACCENT } });
  s.addText("ATLS CLASSIFICATION OF HEMORRHAGE  (11th Ed, 2025)", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.45,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri", margin: 0
  });

  const classes = [
    { cls: "CLASS I", pct: "Up to 15%", hr: "Normal / minimally ↑", sbp: "Normal", other: "No change in pulse pressure or RR", bg: "1E4A1E", border: "2A8A2A" },
    { cls: "CLASS II", pct: "15-30%", hr: "100-120 bpm ↑", sbp: "Minimal change", other: "↓ Pulse pressure, tachypnea (RR 20-24), cool/clammy skin", bg: "4A3A0A", border: "C8941A" },
    { cls: "CLASS III", pct: "30-40%", hr: "≥120 bpm (thready)", sbp: "< 90 mmHg", other: "Mental status changes, ↓ urine output, delayed capillary refill", bg: "4A1A0A", border: ACCENT },
    { cls: "CLASS IV", pct: "> 40%", hr: "> 120 bpm (marked)", sbp: "< 90 mmHg (hypotensive)", other: "Minimal/absent urine, cold/pale skin, narrow pulse pressure (≤25 mmHg)", bg: "6A1A1A", border: "FF2020" },
  ];

  const colLabels = ["", "Blood Loss", "Heart Rate", "Blood Pressure", "Key Signs"];
  const colX = [0.18, 1.3, 2.6, 4.0, 5.6];
  const colW = [1.1, 1.28, 1.38, 1.58, 4.2];

  // Header row
  colLabels.forEach((label, ci) => {
    s.addText(label, { x: colX[ci], y: 0.72, w: colW[ci], h: 0.32,
      fontSize: 11, bold: true, color: ACCENT2, fontFace: "Calibri", align: "center" });
  });

  classes.forEach((c, i) => {
    let y = 1.1 + i * 1.05;
    // Row background
    s.addShape(pres.ShapeType.roundRect, { x: 0.18, y, w: 9.64, h: 0.98,
      fill: { color: c.bg }, line: { color: c.border, width: 1.5 }, rectRadius: 0.06 });
    // Class label
    s.addText(c.cls, { x: 0.22, y: y + 0.12, w: 1.0, h: 0.5,
      fontSize: 14, bold: true, color: c.border, fontFace: "Calibri", align: "center" });
    // Data cells
    const cells = [c.pct, c.hr, c.sbp, c.other];
    cells.forEach((cell, ci) => {
      s.addText(cell, { x: colX[ci + 1], y: y + 0.1, w: colW[ci + 1], h: 0.75,
        fontSize: 11.5, color: WHITE, fontFace: "Calibri", align: "center", valign: "middle", wrap: true });
    });
  });
}

// ═══════════════════════════════════════════════════════
// SLIDE 6 – INITIAL ASSESSMENT (ABCDE)
// ═══════════════════════════════════════════════════════
{
  let s = midSlide(pres);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.65, fill: { color: "1A3A6A" } });
  s.addText("PRIMARY SURVEY — ATLS ABCDE APPROACH", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.45,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri", margin: 0
  });

  const steps = [
    { letter: "A", word: "AIRWAY", color: "E84B3C", desc: "Assess & protect airway — C-spine stabilization. Video laryngoscopy preferred (90% vs 79% first-pass success). Cricothyrotomy kit at bedside for failed airway." },
    { letter: "B", word: "BREATHING", color: "F5A623", desc: "SpO₂ >93%. Rule out tension pneumothorax (immediate needle decompression), massive hemothorax, cardiac tamponade. E-FAST is more sensitive than CXR for pneumothorax." },
    { letter: "C", word: "CIRCULATION", color: "4CAF50", desc: "2 large-bore (≥16G) IVs antecubital fossa. IO access if IV fails (93% success). Control external hemorrhage. FAST exam. Transfuse type O blood for severe shock." },
    { letter: "D", word: "DISABILITY", color: "2196F3", desc: "Glasgow Coma Scale (GCS), pupillary response, gross motor & sensory function. Spinal immobilization if C-spine injury possible. Avoid hypotension with TBI." },
    { letter: "E", word: "EXPOSURE", color: "9C27B0", desc: "Completely undress patient. Examine entire body including scalp, axillae, perineum, back. Prevent hypothermia — heat room, warm fluids, warm blankets." },
  ];

  steps.forEach((step, i) => {
    let y = 0.75 + i * 0.96;
    // Circle for letter
    s.addShape(pres.ShapeType.ellipse, { x: 0.2, y: y + 0.12, w: 0.65, h: 0.65,
      fill: { color: step.color }, line: { color: WHITE, width: 0.5 } });
    s.addText(step.letter, { x: 0.2, y: y + 0.14, w: 0.65, h: 0.55,
      fontSize: 22, bold: true, color: WHITE, align: "center", fontFace: "Calibri" });

    // Word
    s.addText(step.word, { x: 1.0, y: y + 0.08, w: 1.6, h: 0.35,
      fontSize: 13, bold: true, color: step.color, fontFace: "Calibri" });
    // Description
    s.addText(step.desc, { x: 1.0, y: y + 0.4, w: 8.75, h: 0.48,
      fontSize: 11.5, color: LIGHT, fontFace: "Calibri", wrap: true });
  });
}

// ═══════════════════════════════════════════════════════
// SLIDE 7 – HEMORRHAGE CONTROL
// ═══════════════════════════════════════════════════════
{
  let s = darkSlide(pres);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.65, fill: { color: ACCENT } });
  s.addText("HEMORRHAGE CONTROL", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.45,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri", margin: 0
  });

  // Two columns
  // LEFT
  s.addText("External Hemorrhage", { x: 0.3, y: 0.75, w: 4.5, h: 0.38,
    fontSize: 15, bold: true, color: ACCENT2, fontFace: "Calibri" });

  const extBullets = [
    "Direct pressure — primary & preferred method",
    "Hemostatic-impregnated dressing + 3 min pressure",
    "Tourniquet for amputations/severe extremity injury; record time",
    "Junctional tourniquet for shoulder/groin wounds",
    "Scalp: lidocaine+epinephrine injection, Raney clips, or running sutures",
    "Wound packing with gauze or hemostatic agent",
  ];

  s.addText(extBullets.map((b, i) => ({
    text: b,
    options: { bullet: { type: "bullet", code: "25CF", color: ACCENT }, color: LIGHT,
               fontSize: 12, breakLine: true, paraSpaceAfter: 3 }
  })), { x: 0.3, y: 1.15, w: 4.5, h: 3.0, fontFace: "Calibri" });

  // RIGHT
  s.addText("Non-Compressible Hemorrhage", { x: 5.2, y: 0.75, w: 4.5, h: 0.38,
    fontSize: 15, bold: true, color: ACCENT2, fontFace: "Calibri" });

  const intBullets = [
    "Sites: chest, abdomen, retroperitoneum, pelvis, thigh (up to 1L)",
    "FAST / E-FAST: identifies intraperitoneal & pericardial blood",
    "Unstable pelvis: circumferential pelvic binder (open-book fractures)",
    "REBOA (Resuscitative Endovascular Balloon Occlusion of Aorta): for massive pelvic/abdominal trauma",
    "Haemodynamically stable → CT scan for further workup",
    "Unstable → immediate OR or interventional radiology",
    "Early trauma surgery consult is mandatory",
  ];

  s.addText(intBullets.map((b, i) => ({
    text: b,
    options: { bullet: { type: "bullet", code: "25CF", color: "F5A623" }, color: LIGHT,
               fontSize: 12, breakLine: true, paraSpaceAfter: 3 }
  })), { x: 5.2, y: 1.15, w: 4.55, h: 3.0, fontFace: "Calibri" });

  // Divider
  s.addShape(pres.ShapeType.rect, { x: 4.97, y: 0.75, w: 0.06, h: 4.3, fill: { color: ACCENT } });

  // Bottom bar
  s.addShape(pres.ShapeType.rect, { x: 0, y: 4.95, w: 10, h: 0.65, fill: { color: "2A1A0A" } });
  s.addText("⚠  Hypotension generally does not manifest until ≥30% of blood volume is lost — high index of suspicion required", {
    x: 0.3, y: 5.0, w: 9.4, h: 0.5,
    fontSize: 12, color: ACCENT2, bold: true, fontFace: "Calibri"
  });
}

// ═══════════════════════════════════════════════════════
// SLIDE 8 – DAMAGE CONTROL RESUSCITATION
// ═══════════════════════════════════════════════════════
{
  let s = midSlide(pres);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.65, fill: { color: "1A3A6A" } });
  s.addText("DAMAGE CONTROL RESUSCITATION (DCR)", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.45,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri", margin: 0
  });

  const principles = [
    {
      num: "1", title: "Minimize IV Crystalloid",
      desc: "Give only for hypotension (MAP <60-65 mmHg). Max 500 mL boluses. Limit to <1L total. Crystalloid >1.5L associated with 2× increased mortality.",
      color: "C04020"
    },
    {
      num: "2", title: "Transfuse Early — Balanced Ratio",
      desc: "Whole blood or 1:1:1 ratio of PRBCs : FFP : Platelets. Activate Massive Transfusion Protocol (MTP) early. Type O blood available immediately.",
      color: "C08020"
    },
    {
      num: "3", title: "Tranexamic Acid (TXA) — Within 3 Hours",
      desc: "1g IV over 10 min → 1g over 8 hours (or 2g single bolus). CRASH-2: ↓ all-cause mortality (14.5→16%) and bleeding mortality. Benefit ONLY within 3 hours.",
      color: "2060A0"
    },
    {
      num: "4", title: "Permissive Hypotension",
      desc: "Target SBP 70-90 mmHg (MAP 50-65) for penetrating trauma WITHOUT brain injury. For TBI/SCI: maintain MAP ≥85 mmHg. European guidelines: SBP 80-90 mmHg.",
      color: "206A30"
    },
    {
      num: "5", title: "TEG / ROTEM Guided Treatment",
      desc: "Thromboelastography provides faster & more accurate coagulopathy assessment. Guides clotting factor replacement. Reduces unnecessary transfusion.",
      color: "602080"
    },
  ];

  principles.forEach((p, i) => {
    let y = 0.8 + i * 0.94;
    s.addShape(pres.ShapeType.ellipse, { x: 0.2, y: y + 0.1, w: 0.6, h: 0.6,
      fill: { color: p.color }, line: { color: WHITE, width: 0.5 } });
    s.addText(p.num, { x: 0.2, y: y + 0.1, w: 0.6, h: 0.6,
      fontSize: 18, bold: true, color: WHITE, align: "center", valign: "middle", fontFace: "Calibri" });
    s.addText(p.title, { x: 0.95, y: y + 0.06, w: 3.2, h: 0.35,
      fontSize: 13.5, bold: true, color: ACCENT2, fontFace: "Calibri" });
    s.addText(p.desc, { x: 0.95, y: y + 0.4, w: 8.8, h: 0.48,
      fontSize: 11.5, color: LIGHT, fontFace: "Calibri", wrap: true });
  });
}

// ═══════════════════════════════════════════════════════
// SLIDE 9 – MASSIVE TRANSFUSION PROTOCOL (ABC SCORE)
// ═══════════════════════════════════════════════════════
{
  let s = darkSlide(pres);
  s.addShape(pres.ShapeType.rect, { x: 0, y: 0, w: 10, h: 0.65, fill: { color: ACCENT } });
  s.addText("MASSIVE TRANSFUSION PROTOCOL  &  ABC SCORE", {
    x: 0.3, y: 0.1, w: 9.4, h: 0.45,
    fontSize: 20, bold: true, color: WHITE, fontFace: "Calibri", margin: 0
  });

  // ABC Score box LEFT
  s.addShape(pres.ShapeType.roundRect, { x: 0.2, y: 0.8, w: 4.6, h: 3.0,
    fill: { color: "1E1A2E" }, line: { color: ACCENT2, width: 2 }, rectRadius: 0.1 });
  s.addText("ABC SCORE  (Assessment of Blood Consumption)", {
    x: 0.4, y: 0.88, w: 4.2, h: 0.38,
    fontSize: 13, bold: true, color: ACCENT2, fontFace: "Calibri"
  });

  const abcItems = [
    "Penetrating mechanism of injury",
    "Positive FAST exam (evidence of hemorrhage)",
    "SBP ≤ 90 mmHg",
    "Heart rate ≥ 120 bpm",
  ];
  abcItems.forEach((item, i) => {
    let y = 1.35 + i * 0.5;
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    { label: "Moderate hemorrhage:", val: "Same 1:1:1 ratio; transfuse as soon as need recognized" },
    { label: "Hb threshold (non-severe):", val: "< 7 g/dL (or <10 g/dL if ACS risk)" },
    { label: "Platelets:", val: "Transfuse if <50,000/µL" },
    { label: "FFP:", val: "If INR > 2" },
    { label: "Cryoprecipitate:", val: "If fibrinogen <150 mg/dL" },
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// ═══════════════════════════════════════════════════════
// SLIDE 10 – SPECIAL SCENARIOS
// ═══════════════════════════════════════════════════════
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  const scenarios = [
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      title: "🧠 Spinal Cord Injury + Hemorrhage",
      content: "Highest priority: control blood loss first. Target MAP ≥85-90 mmHg (vs 60-65 for other trauma). Add norepinephrine if MAP not achieved after transfusion. Transfer with both blood products and norepinephrine.",
      color: "4A1A7A"
    },
    {
      title: "👴 Older Adult Trauma",
      content: "Beta-blockers may mask tachycardia. Baseline hypertension means 'normal' BP may actually be hypotensive. Many on oral anticoagulants — reverse as appropriate. Decompensate more easily from excess IV fluid or blood loss.",
      color: "1A3A5A"
    },
    {
      title: "🤰 Pregnant Patient",
      content: "Displace uterus to left (>20 wks) to improve cardiac output. Up to 20% blood volume loss before vital sign changes. Obtain obstetrics consult immediately. Continuous fetal heart rate monitoring. Give anti-D immunoglobulin if RhD-negative.",
      color: "1A5A3A"
    },
    {
      title: "💊 Anticoagulated Patient",
      content: "Warfarin: Vitamin K + PCC (4-factor). Dabigatran: Idarucizumab. Factor Xa inhibitors (rivaroxaban/apixaban): Andexanet alfa or 4F-PCC. LMWH: Protamine sulfate. Avoid 4F-PCC empirically in MTP — PROCOAG trial showed no mortality benefit, higher thromboembolism (35% vs 24%).",
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// ═══════════════════════════════════════════════════════
// SLIDE 11 – INDIA: CAUSES & PREVENTION
// ═══════════════════════════════════════════════════════
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    { cause: "Over-speeding", pct: "70.3%" },
    { cause: "Drunk driving", pct: "~4%" },
    { cause: "Red light jumping", pct: "~2%" },
    { cause: "Wrong side driving", pct: "~3%" },
    { cause: "Distracted driving", pct: "~5%" },
    { cause: "Potholes / road defects", pct: "~1.6%" },
    { cause: "Night driving hazards", pct: "Significant" },
  ];

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    "🚨 Enforce speed limits — camera-based, automated penalties",
    "🏥 Strengthen Golden Hour care: expand trauma centers on NH corridors",
    "🚑 Good Samaritan Law awareness to encourage bystander first aid",
    "🛡️ Mandatory helmets, seatbelts — increase conviction rate",
    "🌐 Crash data integration: close MoRTH–NCRB 14,600 deaths data gap",
    "🛣️ Black-spot elimination on National Highways",
    "📱 Intelligent Traffic Management Systems in cities",
    "🎓 Road safety education in schools & for new drivers",
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// ═══════════════════════════════════════════════════════
// SLIDE 12 – KEY TAKEAWAYS
// ═══════════════════════════════════════════════════════
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    { emoji: "🩸", text: "Hemorrhage is the #1 preventable cause of trauma death — rapid control and early transfusion save lives." },
    { emoji: "⏱️", text: "TXA must be given within 3 hours of injury (1g IV + 1g over 8h). After 3 hours, NO benefit." },
    { emoji: "💉", text: "Whole blood or 1:1:1 (PRBCs:FFP:Platelets) is the standard for massive hemorrhage resuscitation." },
    { emoji: "🚫", text: "Minimize crystalloid — >1.5L crystalloid is associated with doubled mortality in trauma patients." },
    { emoji: "🇮🇳", text: "India: 1.77 lakh deaths/year (2024), 485/day. #1 globally. 18-45 age group = 66% of all deaths." },
    { emoji: "🏎️", text: "Over-speeding (70.3%) and two-wheelers (46.2%) dominate India's road death causes." },
    { emoji: "🏥", text: "Only 2.1% of India's roads are National Highways, yet they account for 36.6% of road deaths." },
    { emoji: "🎯", text: "India is far off-track for the WHO SDG 3.6 target of 50% reduction in road deaths by 2030." },
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// ─── WRITE FILE ───
const outputPath = "/home/daytona/workspace/trauma-ppt/Trauma_Management_India_Road_Accidents.pptx";
pres.writeFile({ fileName: outputPath })
  .then(() => console.log(`✅ Saved: ${outputPath}`))
  .catch(err => { console.error("Error:", err); process.exit(1); });