from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.enum.shapes import MSO_SHAPE
import copy

# ---------- Palette ----------
NAVY = RGBColor(0x0B, 0x2E, 0x4E)       # deep medical navy
TEAL = RGBColor(0x11, 0x8A, 0x8F)       # teal accent
LIGHT_TEAL = RGBColor(0xDD, 0xF1, 0xF1)
ORANGE = RGBColor(0xE8, 0x7A, 0x2C)     # alert/accent
WHITE = RGBColor(0xFF, 0xFF, 0xFF)
DARK = RGBColor(0x22, 0x22, 0x22)
GREY = RGBColor(0x5A, 0x5A, 0x5A)
LIGHT_GREY = RGBColor(0xF2, 0xF4, 0xF6)

prs = Presentation()
prs.slide_width = Inches(13.333)
prs.slide_height = Inches(7.5)
SW, SH = prs.slide_width, prs.slide_height
BLANK = prs.slide_layouts[6]


def add_slide():
    return prs.slides.add_slide(BLANK)


def bg_fill(slide, color):
    slide.background.fill.solid()
    slide.background.fill.fore_color.rgb = color


def rect(slide, x, y, w, h, color, line=False):
    shp = slide.shapes.add_shape(MSO_SHAPE.RECTANGLE, x, y, w, h)
    shp.fill.solid()
    shp.fill.fore_color.rgb = color
    if line:
        shp.line.color.rgb = color
        shp.line.width = Pt(0.5)
    else:
        shp.line.fill.background()
    shp.shadow.inherit = False
    return shp


def textbox(slide, x, y, w, h, text, size=18, color=DARK, bold=False, italic=False,
            align=PP_ALIGN.LEFT, font="Calibri", anchor=None, line_spacing=1.0):
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = True
    if anchor:
        tf.vertical_anchor = anchor
    p = tf.paragraphs[0]
    p.text = text
    p.alignment = align
    p.line_spacing = line_spacing
    r = p.runs[0]
    r.font.size = Pt(size)
    r.font.color.rgb = color
    r.font.bold = bold
    r.font.italic = italic
    r.font.name = font
    return tb


def bullets(slide, x, y, w, h, items, size=16, color=DARK, font="Calibri",
            bullet_char="\u25B8", gap=6, bold_lead=False):
    """items: list of str OR (lead, rest) tuples for bold-lead bullets, or (text, level)"""
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = True
    first = True
    for item in items:
        level = 0
        lead = None
        if isinstance(item, tuple) and len(item) == 3:
            text, lead, level = item
        elif isinstance(item, tuple) and len(item) == 2:
            text, level = item
        else:
            text = item
        p = tf.paragraphs[0] if first else tf.add_paragraph()
        first = False
        p.space_after = Pt(gap)
        p.level = 0
        indent = level * 0.28
        pref = "   " if level else ""
        bchar = "\u2013" if level else bullet_char
        if lead:
            r1 = p.add_run()
            r1.text = f"{pref}{bchar}  {lead}: "
            r1.font.bold = True
            r1.font.size = Pt(size)
            r1.font.color.rgb = TEAL if level == 0 else GREY
            r1.font.name = font
            r2 = p.add_run()
            r2.text = text
            r2.font.size = Pt(size)
            r2.font.color.rgb = color
            r2.font.name = font
        else:
            r = p.add_run()
            r.text = f"{pref}{bchar}  {text}"
            r.font.size = Pt(size)
            r.font.color.rgb = color if level == 0 else GREY
            r.font.name = font
    return tb


def footer(slide, num, total=16):
    rect(slide, Inches(0), Inches(7.28), SW, Inches(0.22), NAVY)
    textbox(slide, Inches(0.4), Inches(7.28), Inches(6), Inches(0.22),
            "Role of Anaesthesia in Calamitous Situations", size=9, color=WHITE, font="Calibri")
    textbox(slide, SW - Inches(1.2), Inches(7.28), Inches(0.8), Inches(0.22),
            f"{num}", size=9, color=WHITE, align=PP_ALIGN.RIGHT)


def header(slide, title, kicker=None):
    rect(slide, 0, 0, SW, Inches(1.15), NAVY)
    rect(slide, 0, Inches(1.15), SW, Pt(3), ORANGE)
    if kicker:
        textbox(slide, Inches(0.55), Inches(0.10), Inches(10), Inches(0.3), kicker.upper(),
                size=12, color=ORANGE, bold=True, font="Calibri")
        textbox(slide, Inches(0.55), Inches(0.38), Inches(11.5), Inches(0.7), title,
                size=28, color=WHITE, bold=True, font="Calibri")
    else:
        textbox(slide, Inches(0.55), Inches(0.28), Inches(11.5), Inches(0.75), title,
                size=30, color=WHITE, bold=True, font="Calibri")


def content_slide(num, kicker, title, items, size=17, gap=8, extra_note=None):
    s = add_slide()
    bg_fill(s, WHITE)
    header(s, title, kicker)
    bullets(s, Inches(0.7), Inches(1.55), Inches(11.9), Inches(5.4), items, size=size, gap=gap)
    if extra_note:
        rect(s, Inches(0.55), Inches(6.75), Inches(12.2), Inches(0.02), LIGHT_TEAL)
        textbox(s, Inches(0.7), Inches(6.55), Inches(11.9), Inches(0.5), extra_note,
                size=12, color=GREY, italic=True)
    footer(s, num)
    return s


# ============================================================
# SLIDE 1 — TITLE
# ============================================================
s = add_slide()
bg_fill(s, NAVY)
rect(s, 0, Inches(6.3), SW, Inches(1.2), TEAL)
rect(s, 0, Inches(6.28), SW, Pt(3), ORANGE)
textbox(s, Inches(0.9), Inches(2.15), Inches(11.5), Inches(0.5), "ANAESTHESIOLOGY IN DISASTER MEDICINE",
        size=16, color=ORANGE, bold=True, font="Calibri")
textbox(s, Inches(0.9), Inches(2.65), Inches(11.5), Inches(1.8), "Role of Anaesthesia in\nCalamitous Situations",
        size=42, color=WHITE, bold=True, font="Calibri", line_spacing=1.05)
textbox(s, Inches(0.9), Inches(4.55), Inches(10.5), Inches(0.6),
        "Mass casualty incidents, natural disasters, terrorism, CBRN events and war",
        size=18, color=LIGHT_TEAL, italic=True)
textbox(s, Inches(0.9), Inches(6.55), Inches(9), Inches(0.6),
        "Anaesthesia & Disaster Preparedness", size=15, color=WHITE, bold=True)
# decorative circles
c1 = s.shapes.add_shape(MSO_SHAPE.OVAL, Inches(11.4), Inches(0.4), Inches(1.6), Inches(1.6))
c1.fill.solid(); c1.fill.fore_color.rgb = TEAL; c1.line.fill.background(); c1.shadow.inherit = False
c2 = s.shapes.add_shape(MSO_SHAPE.OVAL, Inches(12.2), Inches(-0.4), Inches(1.0), Inches(1.0))
c2.fill.solid(); c2.fill.fore_color.rgb = ORANGE; c2.line.fill.background(); c2.shadow.inherit = False

# ============================================================
# SLIDE 2 — OVERVIEW / OUTLINE
# ============================================================
s = add_slide()
bg_fill(s, WHITE)
header(s, "Overview", "Outline")
outline = [
    "Defining calamitous situations: natural disasters, mass casualty incidents, terrorism, CBRN, and armed conflict",
    "Why anaesthesiologists are uniquely positioned for disaster response",
    "The four phases of disaster management and the anaesthesiologist's role in each",
    "Triage systems and the anaesthesiologist as a triage officer",
    "Prehospital and field anaesthesia",
    "In-hospital surge response: OR, PACU and ICU conversion",
    "Special scenario: CBRN warfare and nerve agent casualties",
    "Case illustrations and lessons learned",
    "Challenges, training gaps and preparedness recommendations",
]
bullets(s, Inches(0.7), Inches(1.6), Inches(11.9), Inches(5.4),
        [(o,) for o in outline], size=17, gap=14)
footer(s, 2)

# ============================================================
# SLIDE 3 — WHAT IS A "CALAMITOUS SITUATION"
# ============================================================
content_slide(3, "Definitions", "What Is a Calamitous Situation?", [
    ("A disaster/calamity is any event where the number and severity of casualties overwhelms local medical resources, disrupting the normal balance between need and capacity", None, 0),
    ("Natural disasters", "earthquakes, floods, cyclones/hurricanes, tsunamis, wildfires", 0),
    ("Man-made / technological disasters", "building collapse, industrial and transport accidents, fires, structural failures", 0),
    ("Acts of terrorism and mass violence", "bombings, active-shooter events, vehicle-ramming attacks", 0),
    ("CBRN incidents", "chemical, biological, radiological and nuclear attacks or accidents", 0),
    ("Armed conflict / war", "battlefield and civilian casualties in conflict zones", 0),
    ("Pandemics / public health emergencies", "surge in critically ill patients straining ICU and OR capacity", 0),
], size=17, gap=10)

# ============================================================
# SLIDE 4 — WHY ANAESTHESIOLOGISTS
# ============================================================
content_slide(4, "The Central Argument", "Why the Anaesthesiologist Belongs at the Front Line", [
    ("Airway management", "expert, rapid control of the airway is the single most time-critical skill in any mass casualty scene", 0),
    ("Vascular access & resuscitation", "daily practice in difficult IV/IO/central access and fluid-blood resuscitation under pressure", 0),
    ("Perioperative & critical care medicine", "comfortable running multiple critically unstable patients simultaneously", 0),
    ("Pharmacological expertise", "unique knowledge of anticholinesterases and antidotes relevant to nerve-agent poisoning, sedation and analgesia with limited drug supply", 0),
    ("Operating-room resource management", "trained to allocate scarce equipment, drugs and personnel efficiently", 0),
    ("Team leadership under stress", "used to working in high-acuity, time-pressured, multidisciplinary teams", 0),
    ("Yet anaesthesiologists remain inconsistently integrated into hospital disaster plans worldwide, despite this skill overlap", None, 0),
], size=16, gap=9,
    extra_note="Source: The Multiple Casualty Scenario - Role of the Anesthesiologist, Curr Anesthesiol Rep 2020; Miller's Anesthesia, 10e, Ch.64")

# ============================================================
# SLIDE 5 — FOUR PHASES TABLE
# ============================================================
s = add_slide()
bg_fill(s, WHITE)
header(s, "The Disaster Management Cycle", "Framework")
phases = [
    ("MITIGATION", "Risk/hazard analysis; stockpiling drugs, airway & IV equipment; redundancy for oxygen, power, fluids"),
    ("PREPAREDNESS", "Departmental disaster plans; simulation drills; staff training curricula; communication protocols"),
    ("RESPONSE", "Triage, airway control, resuscitation, OR/PACU/ICU surge conversion, regional & field anaesthesia"),
    ("RECOVERY", "Debriefing, restocking supplies, psychological support for staff, revising plans from lessons learned"),
]
colors = [TEAL, NAVY, ORANGE, GREY]
x0 = Inches(0.6)
w = Inches(2.98)
gap = Inches(0.15)
y0 = Inches(1.7)
h = Inches(4.6)
for i, (name, desc) in enumerate(phases):
    x = x0 + i * (w + gap)
    rect(s, x, y0, w, Inches(0.85), colors[i])
    textbox(s, x, y0, w, Inches(0.85), name, size=17, color=WHITE, bold=True,
            align=PP_ALIGN.CENTER, anchor=MSO_ANCHOR.MIDDLE)
    box = rect(s, x, y0 + Inches(0.95), w, h - Inches(0.95), LIGHT_GREY)
    tb = s.shapes.add_textbox(x + Inches(0.15), y0 + Inches(1.1), w - Inches(0.3), h - Inches(1.2))
    tf = tb.text_frame
    tf.word_wrap = True
    p = tf.paragraphs[0]
    p.text = desc
    p.runs[0].font.size = Pt(13.5)
    p.runs[0].font.color.rgb = DARK
textbox(s, Inches(0.6), Inches(6.5), Inches(12.1), Inches(0.5),
        "The anaesthesiologist has an active role in every phase, not response alone.",
        size=14, color=GREY, italic=True)
footer(s, 5)

# ============================================================
# SLIDE 6 — TRIAGE
# ============================================================
content_slide(6, "First Priority on Scene", "Triage: Prioritising Care Under Scarcity", [
    ("Triage", "the process of prioritising and allocating limited resources based on clinical need and urgency, not order of arrival", 0),
    ("START (Simple Triage And Rapid Treatment)", "rapid sort using respiration, perfusion, and mental status into Immediate (Red) / Delayed (Yellow) / Minimal (Green) / Expectant-Deceased (Black)", 0),
    ("Anaesthesiologists are natural triage officers", "trained to rapidly judge airway patency, haemodynamic instability, and need for urgent intervention across many patients at once", 0),
    ("Triage is dynamic", "categories are reassessed repeatedly as resources and patient status change", 0),
    ("Ethical burden", "under crisis standards of care, anaesthesiologists may be required to make ventilator- and OR-allocation decisions when demand exceeds supply", 0),
], size=17, gap=12)

# ============================================================
# SLIDE 7 — PREHOSPITAL / FIELD ANAESTHESIA
# ============================================================
content_slide(7, "Beyond the Operating Room", "Prehospital and Field Anaesthesia", [
    ("Scene response models", "in France, anaesthesiologists are core members of SAMU (prehospital emergency teams) and lead a two-tier red plan (rescue) and white plan (evacuation/resuscitation)", 0),
    ("On-scene procedures", "advanced airway control, regional nerve blocks for orthopaedic injuries en route, ketamine-based analgesia/sedation, damage-control resuscitation", 0),
    ("Field-adapted anaesthesia", "reliance on portable, drug-sparing techniques - ketamine, TIVA, regional blocks - when piped gases, monitors, or ventilators are unavailable", 0),
    ("Global examples", "Egyptian Revolution (2011) - anaesthesiologists ran trauma resuscitation and triaged to ICU/ward; Rana Plaza collapse, Bangladesh (2013) - extensive anaesthesiology role in mass extrication injuries; Israel - anaesthesiologists embedded in mass-casualty response outside the OR", 0),
], size=16, gap=11)

# ============================================================
# SLIDE 8 — IN HOSPITAL SURGE
# ============================================================
content_slide(8, "Inside the Hospital", "In-Hospital Surge: OR, PACU and ICU", [
    ("Operating room as a resource hub", "rapid conversion to a trauma resuscitation and damage-control surgery pipeline; batching of cases; drug and fluid conservation strategies", 0),
    ("Repurposing space for ICU overflow", "PACUs and ORs converted into makeshift ICUs when critical-care bed capacity is exceeded", 0),
    ("Ventilator and sedation management", "anaesthesiologists lead ventilator triage decisions, sedation protocols, and prolonged critical care under crisis standards of care", 0),
    ("Fluid & drug shortage mitigation", "Hurricane Maria (2017) disrupted ~50% of the US IV fluid supply (Puerto Rico manufacturing); anaesthesia departments led conservation strategies - infusion pumps instead of gravity drips, alternative agents", 0),
    ("Simulation & interdisciplinary drills", "improve institutional resilience, rapid-response protocol execution, and coordination with surgery, ED and nursing", 0),
], size=15.5, gap=9,
    extra_note="Source: Miller's Anesthesia, 10e, Ch.64 (Hurricane Maria case); Current Opinion in Anaesthesiology 2025")

# ============================================================
# SLIDE 9 — CBRN
# ============================================================
content_slide(9, "A Special and Growing Threat", "CBRN Warfare and Nerve-Agent Casualties", [
    ("Chemical, Biological, Radiological, Nuclear (CBRN) incidents", "range from state/terrorist attacks (e.g. 1995 Tokyo sarin subway attack, 2001 anthrax letters) to industrial chemical accidents", 0),
    ("Anaesthesiologists as subject-matter experts", "deep familiarity with cholinergic/anticholinergic pharmacology makes them uniquely suited to manage organophosphate/nerve-agent poisoning", 0),
    ("Key antidotal therapy", "atropine (anticholinergic) and pralidoxime (cholinesterase reactivator), titrated alongside airway support and seizure control (benzodiazepines)", 0),
    ("Decontamination and PPE", "casualties must be decontaminated before entering clean treatment areas; airway and anaesthetic procedures performed with appropriate personal protective equipment", 0),
    ("Military-to-civilian translation", "US military CBRN response structure and staged incident management increasingly adapted for civilian hospital planning", 0),
], size=15.5, gap=10,
    extra_note="Source: Miller's Anesthesia, 10e, Ch.64, Section 3 - CBRN Warfare")

# ============================================================
# SLIDE 10 — 9/11 CASE
# ============================================================
content_slide(10, "Lessons from History", "Case Vignette: September 11, 2001", [
    ("Setting", "coordinated terrorist attack on the World Trade Center, New York - nearly 3,000 deaths, mass structural collapse", 0),
    ("Anaesthesiologist-intensivist response", "Dr. J. David Roccaforte (NYU/Bellevue Hospital, 2.5 miles from the site) documented the response in a paper now considered essential disaster-preparedness reading", 0),
    ("Key lesson - communication", "hospital phone lines failed; recommendation for backup radio and satellite communication systems", 0),
    ("Key lesson - surge expectation vs reality", "hospitals prepared for hundreds of survivors requiring surgery, but the collapse produced predominantly fatalities, illustrating the unpredictability of casualty patterns", 0),
    ("Takeaway", "disaster plans must be flexible, regularly rehearsed and built on realistic multi-scenario assumptions", 0),
], size=16.5, gap=11)

# ============================================================
# SLIDE 11 — CHALLENGES
# ============================================================
content_slide(11, "Where the System Falls Short", "Challenges in Anaesthesia Disaster Response", [
    ("Training gap", "most practicing anaesthesiologists receive little to no formal disaster-preparedness education; few residency programs include mass-casualty simulation", 0),
    ("Inconsistent integration", "anaesthesiologists are often excluded from hospital disaster committees and unaware of institutional contingency plans", 0),
    ("Communication breakdowns", "loss of phone/network infrastructure during large-scale events", 0),
    ("Supply chain fragility", "concentration of pharmaceutical/fluid manufacturing in single regions creates nationwide shortage risk (e.g. Hurricane Maria)", 0),
    ("Ethical strain", "resource-allocation and triage decisions under crisis standards of care carry significant moral burden and medico-legal uncertainty", 0),
    ("Five recurring challenges identified in the literature", "leadership, communication, resource/surge capacity, coordination between agencies, and psychosocial support for both patients and providers", 0),
], size=15.5, gap=9,
    extra_note="Source: Hugelius et al., Int J Environ Res Public Health 2020; Naess & Gaarder, Curr Opin Anaesthesiol 2025")

# ============================================================
# SLIDE 12 — PREPAREDNESS RECOMMENDATIONS
# ============================================================
content_slide(12, "A Call to Action", "Strengthening Preparedness: Recommendations", [
    ("Formal curriculum", "incorporate disaster medicine and mass-casualty simulation into anaesthesiology residency training", 0),
    ("Departmental disaster plans", "every anaesthesia department should hold a written, rehearsed plan aligned with the hospital's overall emergency operations plan", 0),
    ("Regular simulation drills", "recurring, realistic exercises with surgery, emergency medicine, nursing and hospital administration", 0),
    ("Redundant communication & supply systems", "radio/satellite backup; diversified drug and fluid sourcing; conservation protocols ready in advance", 0),
    ("Defined leadership roles", "clear designation of anaesthesiologists in triage, airway command and ICU-surge leadership before a crisis occurs", 0),
    ("International learning", "adopt proven models such as the French SAMU prehospital system and military CBRN response frameworks where feasible", 0),
], size=16, gap=10)

# ============================================================
# SLIDE 13 — SUMMARY
# ============================================================
s = add_slide()
bg_fill(s, NAVY)
textbox(s, Inches(0.6), Inches(0.5), Inches(11), Inches(0.9), "Key Takeaways", size=30, color=WHITE, bold=True)
rect(s, Inches(0.6), Inches(1.35), Inches(3.2), Pt(3), ORANGE)
points = [
    "Calamitous situations - natural, man-made, terrorist, CBRN or war-related - overwhelm normal medical capacity and demand rapid, resource-adapted care.",
    "Anaesthesiologists possess a skill set (airway, resuscitation, pharmacology, resource management) that maps directly onto disaster response needs.",
    "Their role spans the full disaster cycle: mitigation, preparedness, response and recovery - not only the acute response phase.",
    "Formal integration, training and simulation are essential to convert this latent capability into a reliable, coordinated disaster response asset.",
]
tb = s.shapes.add_textbox(Inches(0.6), Inches(1.7), Inches(11.8), Inches(5))
tf = tb.text_frame
tf.word_wrap = True
for i, pt in enumerate(points):
    p = tf.paragraphs[0] if i == 0 else tf.add_paragraph()
    p.space_after = Pt(18)
    r = p.add_run()
    r.text = f"{i+1}.  {pt}"
    r.font.size = Pt(18)
    r.font.color.rgb = WHITE
footer(s, 13)

# ============================================================
# SLIDE 14 — REFERENCES
# ============================================================
s = add_slide()
bg_fill(s, WHITE)
header(s, "References", "Sources")
refs = [
    "Miller's Anesthesia, 10th Edition - Chapter 64: Disaster Preparedness and CBRN Warfare (Elsevier)",
    "Kaafarani HMA, et al. The Multiple Casualty Scenario: Role of the Anesthesiologist. Curr Anesthesiol Rep. 2020;10(3):308-316.",
    "Naess PA, Gaarder C. Managing a mass casualty, lessons learned. Curr Opin Anaesthesiol. 2025 (PMID 39937030).",
    "Hugelius K, Becker J, Adolfsson A. Five Challenges When Managing Mass Casualty or Disaster Situations: A Review Study. Int J Environ Res Public Health. 2020;17(9):3068 (PMID 32354076).",
    "Gangadharan M, Hayanga HK, Greenberg R. A Call to Action: Why Anesthesiologists Must Train, Prepare, and Be at the Forefront of Disaster Response for Mass Casualty Incidents. Anesth Analg. 2024 (PMID 38109852).",
    "Tong JL. Mass casualty management. Int Anesthesiol Clin. 2021 (PMID 33587496).",
    "UpToDate: Anesthetic management during mass casualty/disaster scenarios.",
]
bullets(s, Inches(0.7), Inches(1.6), Inches(11.9), Inches(5.3), [(r,) for r in refs], size=15, gap=14)
footer(s, 14)

prs.save("/tmp/workspace/anaesthesia-calamity-ppt/Role_of_Anaesthesia_in_Calamitous_Situations.pptx")
print("Saved.")

import json, base64
from io import BytesIO
from pptx import Presentation
from pptx.util import Inches, Pt
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.enum.shapes import MSO_SHAPE

# ---------- Palette ----------
NAVY = RGBColor(0x0B, 0x2E, 0x4E)
TEAL = RGBColor(0x11, 0x8A, 0x8F)
LIGHT_TEAL = RGBColor(0xDD, 0xF1, 0xF1)
ORANGE = RGBColor(0xE8, 0x7A, 0x2C)
WHITE = RGBColor(0xFF, 0xFF, 0xFF)
DARK = RGBColor(0x22, 0x22, 0x22)
GREY = RGBColor(0x5A, 0x5A, 0x5A)
LIGHT_GREY = RGBColor(0xF2, 0xF4, 0xF6)

imgs = json.load(open("/tmp/workspace/anaesthesia-calamity-ppt/images.json"))
IMG = {}
for x in imgs:
    if x["base64"]:
        header, b64 = x["base64"].split(",", 1) if "," in x["base64"] else (None, x["base64"])
        IMG[x["url"]] = BytesIO(base64.b64decode(b64))

CENTRAL_LINE_IMG = IMG["https://cdn.orris.care/cdss_images/8ab08e68ee3e5193b4f8f1cc11122488eb55e4561f0053b360a2e1fe6837b8d3.png"]
CBRN_DIAGRAM_IMG = IMG["https://cdn.orris.care/cdss_images/f97de99355f01e1996cb391ce4a8d2fe36e0490f0058857e7922226afe425c67.png"]
FLU_1918_IMG = IMG["https://cdn.orris.care/cdss_images/df29749d8d4721ce75c6174b2c606cb22552efc4e9e352bfcfee98bd29dad0aa.png"]

prs = Presentation()
prs.slide_width = Inches(13.333)
prs.slide_height = Inches(7.5)
SW, SH = prs.slide_width, prs.slide_height
BLANK = prs.slide_layouts[6]


def add_slide():
    return prs.slides.add_slide(BLANK)


def bg_fill(slide, color):
    slide.background.fill.solid()
    slide.background.fill.fore_color.rgb = color


def rect(slide, x, y, w, h, color):
    shp = slide.shapes.add_shape(MSO_SHAPE.RECTANGLE, x, y, w, h)
    shp.fill.solid()
    shp.fill.fore_color.rgb = color
    shp.line.fill.background()
    shp.shadow.inherit = False
    return shp


def textbox(slide, x, y, w, h, text, size=18, color=DARK, bold=False, italic=False,
            align=PP_ALIGN.LEFT, font="Calibri", anchor=None, line_spacing=1.0):
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = True
    if anchor:
        tf.vertical_anchor = anchor
    p = tf.paragraphs[0]
    p.text = text
    p.alignment = align
    p.line_spacing = line_spacing
    r = p.runs[0]
    r.font.size = Pt(size)
    r.font.color.rgb = color
    r.font.bold = bold
    r.font.italic = italic
    r.font.name = font
    return tb


def bullets(slide, x, y, w, h, items, size=16, color=DARK, font="Calibri",
            bullet_char="\u25B8", gap=6):
    tb = slide.shapes.add_textbox(x, y, w, h)
    tf = tb.text_frame
    tf.word_wrap = True
    first = True
    for item in items:
        level = 0
        lead = None
        if isinstance(item, tuple) and len(item) == 3:
            text, lead, level = item
        elif isinstance(item, tuple) and len(item) == 2:
            text, level = item
        else:
            text = item[0] if isinstance(item, tuple) else item
        p = tf.paragraphs[0] if first else tf.add_paragraph()
        first = False
        p.space_after = Pt(gap)
        indent = level * 0.28
        pref = "   " if level else ""
        bchar = "\u2013" if level else bullet_char
        if lead:
            r1 = p.add_run()
            r1.text = f"{pref}{bchar}  {lead}: "
            r1.font.bold = True
            r1.font.size = Pt(size)
            r1.font.color.rgb = TEAL if level == 0 else GREY
            r1.font.name = font
            r2 = p.add_run()
            r2.text = text
            r2.font.size = Pt(size)
            r2.font.color.rgb = color
            r2.font.name = font
        else:
            r = p.add_run()
            r.text = f"{pref}{bchar}  {text}"
            r.font.size = Pt(size)
            r.font.color.rgb = color if level == 0 else GREY
            r.font.name = font
    return tb


def footer(slide, num):
    rect(slide, Inches(0), Inches(7.28), SW, Inches(0.22), NAVY)
    textbox(slide, Inches(0.4), Inches(7.28), Inches(8), Inches(0.22),
            "Role of the Anaesthetist in Calamitous Situations  |  Based on Miller's Anesthesia, 10e (Ch. 64)",
            size=8.5, color=WHITE, font="Calibri")
    textbox(slide, SW - Inches(1.0), Inches(7.28), Inches(0.7), Inches(0.22),
            f"{num}", size=9, color=WHITE, align=PP_ALIGN.RIGHT)


def header(slide, title, kicker=None):
    rect(slide, 0, 0, SW, Inches(1.15), NAVY)
    rect(slide, 0, Inches(1.15), SW, Pt(3), ORANGE)
    if kicker:
        textbox(slide, Inches(0.55), Inches(0.10), Inches(11), Inches(0.3), kicker.upper(),
                size=12, color=ORANGE, bold=True, font="Calibri")
        textbox(slide, Inches(0.55), Inches(0.38), Inches(11.8), Inches(0.7), title,
                size=27, color=WHITE, bold=True, font="Calibri")
    else:
        textbox(slide, Inches(0.55), Inches(0.28), Inches(11.8), Inches(0.75), title,
                size=30, color=WHITE, bold=True, font="Calibri")


def content_slide(num, kicker, title, items, size=17, gap=8, extra_note=None):
    s = add_slide()
    bg_fill(s, WHITE)
    header(s, title, kicker)
    bullets(s, Inches(0.7), Inches(1.5), Inches(11.9), Inches(5.5), items, size=size, gap=gap)
    if extra_note:
        rect(s, Inches(0.55), Inches(6.75), Inches(12.2), Inches(0.02), LIGHT_TEAL)
        textbox(s, Inches(0.7), Inches(6.55), Inches(11.9), Inches(0.5), extra_note,
                size=11.5, color=GREY, italic=True)
    footer(s, num)
    return s


def image_slide(num, kicker, title, items, img_stream, caption, size=15, gap=8):
    s = add_slide()
    bg_fill(s, WHITE)
    header(s, title, kicker)
    bullets(s, Inches(0.6), Inches(1.5), Inches(6.9), Inches(5.4), items, size=size, gap=gap)
    img_stream.seek(0)
    pic = s.shapes.add_picture(img_stream, Inches(7.75), Inches(1.6), width=Inches(5.0))
    if pic.height > Inches(4.6):
        ratio = Inches(4.6) / pic.height
        pic.height = Inches(4.6)
        pic.width = int(pic.width * ratio)
        pic.left = Inches(7.75) + (Inches(5.0) - pic.width) // 2
    textbox(s, Inches(7.75), Inches(6.25), Inches(5.0), Inches(0.6), caption,
            size=10.5, color=GREY, italic=True, align=PP_ALIGN.CENTER)
    footer(s, num)
    return s


# ============================================================
# 1 — TITLE
# ============================================================
s = add_slide()
bg_fill(s, NAVY)
rect(s, 0, Inches(6.3), SW, Inches(1.2), TEAL)
rect(s, 0, Inches(6.28), SW, Pt(3), ORANGE)
textbox(s, Inches(0.9), Inches(2.0), Inches(11.5), Inches(0.5), "DISASTER PREPAREDNESS AND RESPONSE",
        size=16, color=ORANGE, bold=True, font="Calibri")
textbox(s, Inches(0.9), Inches(2.5), Inches(11.5), Inches(1.8), "Role of the Anaesthetist in\nCalamitous Situations",
        size=40, color=WHITE, bold=True, font="Calibri", line_spacing=1.05)
textbox(s, Inches(0.9), Inches(4.4), Inches(10.7), Inches(0.6),
        "Natural disasters \u2022 Terrorism \u2022 CBRN warfare \u2022 Epidemics and pandemics",
        size=17, color=LIGHT_TEAL, italic=True)
textbox(s, Inches(0.9), Inches(6.55), Inches(10.5), Inches(0.6),
        "Based on Miller's Anesthesia, 10th Edition \u2014 Chapter 64: Disaster Preparedness and Response",
        size=14, color=WHITE, bold=True)
c1 = s.shapes.add_shape(MSO_SHAPE.OVAL, Inches(11.4), Inches(0.4), Inches(1.6), Inches(1.6))
c1.fill.solid(); c1.fill.fore_color.rgb = TEAL; c1.line.fill.background(); c1.shadow.inherit = False
c2 = s.shapes.add_shape(MSO_SHAPE.OVAL, Inches(12.2), Inches(-0.4), Inches(1.0), Inches(1.0))
c2.fill.solid(); c2.fill.fore_color.rgb = ORANGE; c2.line.fill.background(); c2.shadow.inherit = False

# ============================================================
# 2 — KEY POINTS (chapter opening key points)
# ============================================================
content_slide(2, "Chapter Key Points", "Why This Chapter Matters", [
    ("Anesthesiologists possess a combination of knowledge and procedural skills that make them critical participants in the immediate and ongoing response to large-scale disasters, provided they are willing to modify their traditional workflow", None, 0),
    ("Natural disasters", "earthquakes, hurricanes, floods, tsunamis and tornadoes require major resources and cause massive interruption of normal health care delivery", 0),
    ("Resource-limited deployment", "anesthesiologists travelling from resource-rich to resource-limited settings must cope with unfamiliar infectious diseases and personal physical/mental stressors with lasting effects", 0),
    ("Terrorism and mass violence", "over 19,000 people were shot and killed or wounded in mass shootings in the US between 2015-2022; all anesthesiologists must be prepared to care for multiple victims", 0),
    ("CBRN threats", "anesthesiologists need the knowledge to care for chemical, biological, radiologic or nuclear disaster victims, and must protect themselves against becoming the \"second victim\"", 0),
    ("Pandemics", "place incredible strain on health systems; anesthesiologists serve as airway/critical-care specialists and infection-control consultants", 0),
], size=15.5, gap=9,
    extra_note="Source: Miller's Anesthesia, 10th Edition, Chapter 64 (Johnson DW, Mulvoy WP, Schnabel ER, Lisco SJ) - Key Points")

# ============================================================
# 3 — CHAPTER STRUCTURE / OUTLINE
# ============================================================
s = add_slide()
bg_fill(s, WHITE)
header(s, "Chapter Structure", "Roadmap")
sections = [
    ("SECTION 1", "Natural Disasters", "Earthquakes, hurricanes, floods, tsunamis \u2013 Haiti earthquake, USNS Comfort, Hurricane Maria"),
    ("SECTION 2", "Acts of Terrorism", "Mass shootings, bombings \u2013 September 11, 2001 World Trade Center attack"),
    ("SECTION 3", "CBRN Warfare", "Chemical, Biological, Radiologic, Nuclear \u2013 Tokyo sarin attack, anthrax letters, incident management"),
    ("SECTION 4", "Epidemic & Pandemic Outbreaks", "Influenza A, SARS, MERS, Ebola, COVID-19 \u2013 personal protection and airway risk"),
]
colors = [TEAL, NAVY, ORANGE, GREY]
x0 = Inches(0.6); w = Inches(2.98); gap = Inches(0.15); y0 = Inches(1.7); h = Inches(4.7)
for i, (tag, name, desc) in enumerate(sections):
    x = x0 + i * (w + gap)
    rect(s, x, y0, w, Inches(1.15), colors[i])
    textbox(s, x + Inches(0.1), y0 + Inches(0.08), w - Inches(0.2), Inches(0.3), tag,
            size=12, color=WHITE, bold=True, align=PP_ALIGN.CENTER)
    textbox(s, x + Inches(0.1), y0 + Inches(0.38), w - Inches(0.2), Inches(0.7), name,
            size=15, color=WHITE, bold=True, align=PP_ALIGN.CENTER)
    rect(s, x, y0 + Inches(1.15), w, h - Inches(1.15), LIGHT_GREY)
    tb = s.shapes.add_textbox(x + Inches(0.15), y0 + Inches(1.3), w - Inches(0.3), h - Inches(1.4))
    tf = tb.text_frame; tf.word_wrap = True
    p = tf.paragraphs[0]; p.text = desc
    p.runs[0].font.size = Pt(13); p.runs[0].font.color.rgb = DARK
footer(s, 3)

# ============================================================
# 4 — SECTION 1 INTRO: NATURAL DISASTERS
# ============================================================
content_slide(4, "Section 1", "Natural Disasters: The Setting", [
    ("Scope", "earthquakes, hurricanes, floods, tsunamis, and tornadoes cause massive disruption to the population and to health care delivery during and after the event", 0),
    ("Prehospital breakdown", "damage to roads can completely disrupt transport of victims and other clinical needs", 0),
    ("In-hospital breakdown", "loss of water, oxygen, fuel, electricity, and other utilities disrupts hospital care; hospitals themselves may be damaged or destroyed", 0),
    ("Communication failure", "telecommunication systems are damaged and simultaneously overloaded as families and victims try to locate one another", 0),
    ("Approach in this chapter", "historical examples (Haiti earthquake, Hurricane Maria) are used to highlight the anaesthesiologist's critical role in management and recovery", 0),
], size=17, gap=12)

# ============================================================
# 5 — CASE: HAITI EARTHQUAKE 2010
# ============================================================
content_slide(5, "Section 1 \u2013 Case Study", "Earthquakes: Haiti, January 12, 2010", [
    ("Scale of destruction", "magnitude 7.0 earthquake; death toll exceeded 130,000 with 1.5 million immediately displaced; over 80% of schools and 50% of hospitals destroyed", 0),
    ("International response", "surgeons, anesthesiologists and other health care providers travelled from the US and elsewhere to provide trauma care and backfill Haitian health workers lost or injured", 0),
    ("Logistics bottleneck", "the single Haitian airport became the key limiting factor; the US Air Force assumed air-traffic control until local authorities recovered", 0),
    ("USNS Comfort hospital ship", "deployed within 72 hours; the largest disaster-relief operation in its history \u2013 over 850 patients treated (237 children), 843 operations on 454 patients over five weeks, including 58 amputations", 0),
    ("Anaesthetist's role", "volunteer anesthesiologists and specialists staffed the ship alongside military physicians, providing anesthesia for extremity trauma and reconstructive surgery", 0),
], size=15, gap=9,
    extra_note="Source: Miller's Anesthesia, 10e, Ch.64, Section 1 \u2013 Natural Disasters (Earthquakes)")

# ============================================================
# 6 — CASE: HURRICANE MARIA 2017
# ============================================================
content_slide(6, "Section 1 \u2013 Case Study", "Hurricanes: Maria and the Drug/Fluid Shortage of 2017", [
    ("Different mortality pattern", "hurricanes tend to cause fewer immediate fatalities than earthquakes or tsunamis, but flooding can cripple medical and surgical care with long-term downstream consequences", 0),
    ("Puerto Rico's manufacturing role", "the island produces a large share of pharmaceuticals and medical devices \u2013 Baxter factories alone supplied roughly 50% of all 0.9% normal saline bags used daily in US hospitals", 0),
    ("National shortage", "factory shutdowns caused an immediate nationwide shortage of IV fluids and medications across the United States, not only in Puerto Rico", 0),
    ("Anaesthesiologist-led conservation", "at the University of Nebraska Medical Center, anesthesiologists worked with pharmacists, nurses and administration to design strategies to avoid critical shortages", 0),
    ("Practical changes", "IV fluids in operating rooms were required to run on infusion pumps rather than gravity drip; alternative fluids and medications were adopted; providers were forced to think critically about every millilitre given", 0),
], size=14.5, gap=8,
    extra_note="Source: Miller's Anesthesia, 10e, Ch.64, Section 1 \u2013 Natural Disasters (Hurricanes)")

# ============================================================
# 7 — SECTION 2: TERRORISM
# ============================================================
content_slide(7, "Section 2", "Acts of Terrorism", [
    ("Rising threat", "as acts of terrorism have accelerated in recent decades, anesthesiologists need the knowledge and skills to care for victims of chemical, biologic, radiologic or nuclear (CBRN) disasters as well as conventional attacks", 0),
    ("Mass shootings", "over 19,000 people were shot and killed or wounded in mass shootings in the US between 2015 and 2022 \u2013 every anesthesiologist must be ready to care for multiple simultaneous victims", 0),
    ("System-wide impact", "the effect of a terror attack extends beyond immediate casualties to strain the entire health system, requiring altered traditional roles and appropriate triage", 0),
    ("Self-protection", "a top priority after any attack is preventing health care workers from becoming the \"second victim\"; appropriate PPE must be readily available", 0),
], size=17, gap=13)

# ============================================================
# 8 — CASE: 9/11
# ============================================================
content_slide(8, "Section 2 \u2013 Case Study", "September 11, 2001: World Trade Center", [
    ("The event", "coordinated attack on the World Trade Center, New York \u2013 nearly 3,000 deaths and collapse of both 110-story towers", 0),
    ("Anaesthesiologist on the front line", "Dr. J. David Roccaforte, an anesthesiologist-intensivist from NYU, was on duty at Bellevue Hospital 2.5 miles from the site; his account remains essential disaster-preparedness reading", 0),
    ("Communications failure", "hospital phone lines became non-functional in the hours after the attack, prompting recommendations for backup radio and satellite-based communication equipment", 0),
    ("Mismatch of expected vs. actual casualties", "hospitals prepared for hundreds of survivors requiring surgery, but the building collapse produced predominantly fatalities rather than a large surge of operable trauma patients", 0),
    ("Key lesson", "many disasters, unlike hurricanes, cannot be anticipated \u2013 prospective plans for triage and inter-hospital coordination must be developed and continually updated", 0),
], size=15, gap=9,
    extra_note="Source: Miller's Anesthesia, 10e, Ch.64, Section 2 \u2013 Acts of Terrorism")

# ============================================================
# 9 — SECTION 3: CBRN DEFINED
# ============================================================
content_slide(9, "Section 3", "CBRN Warfare: Hazards Defined", [
    ("CBRN", "Chemical, Biological, Radiologic, and Nuclear hazards capable of producing massive casualties; the threat is not limited to sophisticated state actors", 0),
    ("Anthrax letters, 2001", "biological agent (anthrax powder) mailed to two US senators raised public awareness of domestic CBRN threats; postal workers who handled the letters became ill", 0),
    ("Tokyo sarin subway attack", "a nerve-agent (chemical) attack that produced key lessons for CBRN preparedness, summarized in the chapter as \"lessons learned\" for future responders", 0),
    ("Anaesthesiologist as subject-matter expert", "deep knowledge of cholinergic and anticholinergic pharmacology makes anesthesiologists uniquely positioned to manage nerve-agent (organophosphate) poisoning", 0),
    ("Mass casualty CBRN response", "the structure, function and focus of the US military's CBRN approach can be adapted to the civilian sector wherever feasible to improve patient care while minimizing collateral risk", 0),
], size=15.5, gap=9,
    extra_note="Source: Miller's Anesthesia, 10e, Ch.64, Section 3 \u2013 CBRN Warfare; Box 64.1 Tokyo Sarin Gas Lessons Learned")

# ============================================================
# 10 — CBRN INCIDENT MANAGEMENT (image slide)
# ============================================================
image_slide(10, "Section 3", "CBRN Incident Management and PPE",
    [
        ("Coordinated response structure", "Domestic CBRN response links Federal agencies, the Department of Homeland Security, State and Local authorities, local first responders, non-governmental organizations, and DoD support around the incident area", 0),
        ("Basic provider rules (Box 64.2)", "self-protection first, recognize the hazard, avoid becoming a casualty, and decontaminate before treating", 0),
        ("PPE is essential", "appropriate personal protective equipment, including self-contained breathing apparatus (SCBA) where indicated, must be available before providers approach casualties", 0),
        ("TOXALS mnemonic", "expands ACLS/ATLS/BLS for chemical, biological and radiological attacks: Airway, Breathing, Circulation, Disability, Drugs, Exposure, Environment (ABCDDEE)", 0),
    ],
    CBRN_DIAGRAM_IMG,
    "Fig. from Miller's Anesthesia, 10e: Domestic CBRN response coordination across Federal, State, Local, DoD, and NGO partners",
    size=13.5, gap=10)

# ============================================================
# 11 — CBRN SUMMARY / ROLE
# ============================================================
content_slide(11, "Section 3 \u2013 Summary", "The Anaesthesiologist's Role in CBRN Events", [
    ("Not every casualty goes to the OR", "many emergency responders and providers require support in triage, ED consultation, pain management, or ICU stabilization rather than immediate surgery", 0),
    ("Core responsibility retained", "the anesthesiologist's main duty within the health system remains optimizing perioperative anesthetic care", 0),
    ("But broader expertise applies", "advanced knowledge of medicine, pharmacology, trauma and resuscitation makes anesthesiologists ideal emergency-response team members", 0),
    ("Proactive stabilization", "it is imperative to be proactive within the hospital or emergency response system, helping triage and stabilize CBRN casualties prior to arrival in the preoperative area or ICU", 0),
], size=17, gap=13,
    extra_note="Source: Miller's Anesthesia, 10e, Ch.64 \u2013 Summary of CBRN Section")

# ============================================================
# 12 — SECTION 4: EPIDEMICS AND PANDEMICS OVERVIEW
# ============================================================
content_slide(12, "Section 4", "Epidemic and Pandemic Infectious Outbreaks", [
    ("A newly proven role", "prior to 2020, the anesthesiologist's role in epidemics/pandemics was discussed largely in the abstract; COVID-19 made it concrete and global", 0),
    ("Historical precedent", "Dr. Bjorn Ibsen's use of positive-pressure ventilation saved many lives in the 1952 Copenhagen polio epidemic \u2013 an early landmark for anesthesiologist-led critical care", 0),
    ("Modern outbreaks", "the role expanded further during the 2003 SARS epidemic, the 2014 West African Ebola epidemic, and the COVID-19 pandemic (2020-present)", 0),
    ("Dual risk", "anesthesiologists functioned both as caregivers and as personnel at elevated personal risk, given their central role in airway management and critical care", 0),
    ("Influenza pandemics", "at least ten pandemic influenza A events have occurred over the past 300 years; the 1918 \u201cSpanish Flu\u201d killed an estimated 50-100 million people worldwide, and the 2009 H1N1 pandemic caused roughly 284,000 deaths globally", 0),
], size=14.5, gap=8,
    extra_note="Source: Miller's Anesthesia, 10e, Ch.64, Section 4 \u2013 Epidemic and Pandemic Infectious Outbreaks")

# ============================================================
# 13 — PANDEMIC IMAGE SLIDE (1918 flu + SARS/MERS/Ebola)
# ============================================================
image_slide(13, "Section 4", "From 1918 Influenza to Ebola: Lessons for Anaesthesia",
    [
        ("1918 pandemic", "mass wards were used to care for overwhelming numbers of influenza patients, foreshadowing modern surge-capacity challenges", 0),
        ("SARS (2003) and MERS", "both coronaviruses required strict isolation strategies and highlighted the anesthesiologist's role as an infection-control consultant during airway management", 0),
        ("Ebola virus disease (2014)", "anesthesiologist-intensivists at the Nebraska Biocontainment Unit cared for patients with Ebola, performing procedures such as ultrasound-guided central venous access in full PPE", 0),
        ("Transmission-based PPE selection", "droplet, contact, and airborne precautions each require different PPE and ventilation strategies, directly affecting how anesthesia and airway procedures are performed", 0),
    ],
    FLU_1918_IMG,
    "Fig. 64.16, Miller's Anesthesia, 10e: Mass care of patients during the 1918 influenza pandemic",
    size=13.5, gap=10)

# ============================================================
# 14 — COVID-19 AND PERSONAL PROTECTION (image slide with central line photo)
# ============================================================
image_slide(14, "Section 4", "COVID-19: Airway Risk and Personal Protection",
    [
        ("Scale", "SARS-CoV-2 caused over 758 million confirmed cases and 6.8 million deaths worldwide (as of March 2023), overwhelming health systems globally", 0),
        ("Aerosol-generating procedures", "intubation, extubation, bronchoscopy and other airway manoeuvres performed by anesthesiologists carry elevated transmission risk, driving evolving PPE and airborne-precaution guidance", 0),
        ("Anesthesiologist-intensivists on the front line", "at biocontainment units such as Nebraska's, anesthesiologists placed central lines and managed airways for Ebola and later COVID-19 patients in full protective equipment", 0),
        ("Enduring principle", "knowledge of the disease, its management, and infection-control measures is critical for anesthesiologists both to contribute maximally and to protect themselves", 0),
    ],
    CENTRAL_LINE_IMG,
    "Fig. 64.21, Miller's Anesthesia, 10e: Anesthesiologist placing an ultrasound-guided central venous line in the Nebraska Biocontainment Unit",
    size=13, gap=9)

# ============================================================
# 15 — OVERALL SUMMARY
# ============================================================
s = add_slide()
bg_fill(s, NAVY)
textbox(s, Inches(0.6), Inches(0.5), Inches(11), Inches(0.9), "Key Takeaways", size=30, color=WHITE, bold=True)
rect(s, Inches(0.6), Inches(1.35), Inches(3.2), Pt(3), ORANGE)
points = [
    "Across natural disasters, terrorism, CBRN warfare and pandemics, the anesthesiologist's airway, resuscitation, pharmacology and critical-care skills translate directly into disaster-response value.",
    "The anesthesiologist's role extends well beyond the operating room: prehospital-adjacent triage, ED and ICU stabilization, resource conservation, and infection control.",
    "Historical events - Haiti 2010, Hurricane Maria 2017, September 11 2001, the Tokyo sarin attack, and COVID-19 - each generated concrete lessons that should shape institutional disaster planning.",
    "Self-protection (appropriate PPE, decontamination, avoiding becoming the \"second victim\") is a non-negotiable first principle in every calamity type.",
    "Being proactive - triaging and stabilizing patients before they reach the OR or ICU - is repeatedly identified as the anesthesiologist's highest-value contribution.",
]
tb = s.shapes.add_textbox(Inches(0.6), Inches(1.7), Inches(11.9), Inches(5.2))
tf = tb.text_frame
tf.word_wrap = True
for i, pt in enumerate(points):
    p = tf.paragraphs[0] if i == 0 else tf.add_paragraph()
    p.space_after = Pt(14)
    r = p.add_run()
    r.text = f"{i+1}.  {pt}"
    r.font.size = Pt(16.5)
    r.font.color.rgb = WHITE
footer(s, 15)

# ============================================================
# 16 — REFERENCE
# ============================================================
s = add_slide()
bg_fill(s, WHITE)
header(s, "Reference", "Source")
refs = [
    "Johnson DW, Mulvoy WP, Schnabel ER, Lisco SJ. Chapter 64: Disaster Preparedness and Response. In: Gropper MA, et al., eds. Miller's Anesthesia, 10th Edition. Philadelphia: Elsevier; 2024.",
    "Chapter sections referenced: Section 1 (Natural Disasters), Section 2 (Acts of Terrorism), Section 3 (Chemical, Biological, Radiologic, and Nuclear [CBRN] Warfare), Section 4 (Epidemic and Pandemic Infectious Outbreaks).",
    "Figures referenced: Fig. 64.16 (1918 influenza pandemic mass care); domestic CBRN response coordination diagram; Fig. 64.21 (Nebraska Biocontainment Unit).",
    "All clinical content, case examples, and statistics in this presentation are drawn directly from the above chapter of Miller's Anesthesia, 10th Edition.",
]
bullets(s, Inches(0.7), Inches(1.7), Inches(11.9), Inches(5.0), [(r,) for r in refs], size=16, gap=18)
footer(s, 16)

prs.save("/tmp/workspace/anaesthesia-calamity-ppt/Role_of_Anaesthetist_in_Calamitous_Situations_Millers.pptx")
print("Saved.")