cd "/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/" && python3 -c " import pdfplumber with pdfplumber.open('DocScanner 28 Jul 2026 12-18 pm(1).pdf') as pdf: print(f'Pages: {len(pdf.pages)}') for i, page in enumerate(pdf.pages): print(f'--- Page {i+1} ---') text = page.extract_text() print(text) print() "

ls "/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/"

python3 -c " import pdfplumber path = \"/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/DocScanner 28 Jul 2026 12-18 pm(1).pdf\" with pdfplumber.open(path) as pdf: print(f'Pages: {len(pdf.pages)}') for i, page in enumerate(pdf.pages): print(f'--- Page {i+1} ---') text = page.extract_text() print(text) print() "

cp "/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/DocScanner 28 Jul 2026 12-18 pm(1).pdf" /tmp/workspace/input.pdf && echo "Copied OK"

find /tmp/workspace/attachments -type f 2>/dev/null; ls -la /tmp/workspace/attachments/ 2>/dev/null

INFILE="/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/DocScanner 28 Jul 2026 12-18 pm(1).pdf" python3 << 'EOF' import pdfplumber, sys path = "/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/DocScanner 28 Jul 2026 12-18 pm(1).pdf" import os print("Exists:", os.path.isfile(path)) print("Size:", os.path.getsize(path) if os.path.isfile(path) else "N/A") EOF

python3 -c " import os, glob base = '/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/' files = os.listdir(base) print(files) for f in files: full = os.path.join(base, f) print(repr(full), os.path.isfile(full), os.path.getsize(full)) "

python3 << 'PYEOF' import os, pdfplumber base = '/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/' fname = os.listdir(base)[0] path = os.path.join(base, fname) print("Opening:", repr(path)) with pdfplumber.open(path) as pdf: print(f"Total pages: {len(pdf.pages)}") for i, page in enumerate(pdf.pages): print(f"\n--- Page {i+1} ---") text = page.extract_text() if text: print(text[:2000]) else: print("[No text found - likely scanned image]") # Check for images imgs = page.images print(f" Images on page: {len(imgs)}") PYEOF

python3 << 'PYEOF' import os, pdfplumber from PIL import Image import io base = '/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/' fname = os.listdir(base)[0] path = os.path.join(base, fname) os.makedirs('/tmp/workspace/pages', exist_ok=True) with pdfplumber.open(path) as pdf: for i, page in enumerate(pdf.pages): # Extract images for j, img in enumerate(page.images): print(f"Page {i+1}, img {j}: {img}") break # Render page as image using page's bbox img_obj = page.to_image(resolution=150) out_path = f'/tmp/workspace/pages/page_{i+1}.png' img_obj.save(out_path) print(f"Saved page {i+1} to {out_path}") PYEOF

python3 << 'PYEOF' import os from reportlab.lib.pagesizes import A4 from reportlab.lib import colors from reportlab.lib.units import mm from reportlab.pdfgen import canvas from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.platypus import SimpleDocTemplate, Paragraph, Spacer, Image as RLImage, PageBreak from reportlab.lib.enums import TA_CENTER, TA_LEFT import pdfplumber from PIL import Image as PILImage base = '/tmp/workspace/attachments/dfa2ec65-a86a-4c49-9d0f-a57c7e9e0ed0/' fname = os.listdir(base)[0] src_path = os.path.join(base, fname) os.makedirs('/tmp/workspace/output', exist_ok=True) output_path = '/tmp/workspace/output/Anaesthesia_Notes_Enhanced.pdf' # Extract high-res images from PDF page_images = [] with pdfplumber.open(src_path) as pdf: for i, page in enumerate(pdf.pages): img_obj = page.to_image(resolution=200) img_path = f'/tmp/workspace/pages/hires_page_{i+1}.png' img_obj.save(img_path) page_images.append(img_path) print(f"Extracted page {i+1} at high res") print("All pages extracted:", page_images) PYEOF

python3 << 'PYEOF' import os from reportlab.lib.pagesizes import A4 from reportlab.lib import colors from reportlab.lib.units import mm from reportlab.pdfgen import canvas from PIL import Image as PILImage page_images = [f'/tmp/workspace/pages/hires_page_{i+1}.png' for i in range(4)] output_path = '/tmp/workspace/output/Anaesthesia_Notes_Enhanced.pdf' W, H = A4 # 595.28 x 841.89 points c = canvas.Canvas(output_path, pagesize=A4) # ── COVER PAGE ────────────────────────────────────────────────────────────── # Dark navy gradient background via filled rect c.setFillColor(colors.HexColor('#0D1B2A')) c.rect(0, 0, W, H, fill=1, stroke=0) # Top accent bar c.setFillColor(colors.HexColor('#1B9AAA')) c.rect(0, H - 12*mm, W, 12*mm, fill=1, stroke=0) # Bottom accent bar c.setFillColor(colors.HexColor('#1B9AAA')) c.rect(0, 0, W, 10*mm, fill=1, stroke=0) # Left side accent stripe c.setFillColor(colors.HexColor('#EF476F')) c.rect(0, 10*mm, 8*mm, H - 22*mm, fill=1, stroke=0) # Medical cross symbol cross_x, cross_y = 80*mm, H - 60*mm c.setFillColor(colors.HexColor('#EF476F')) # horizontal bar c.rect(cross_x - 15*mm, cross_y - 5*mm, 30*mm, 10*mm, fill=1, stroke=0) # vertical bar c.rect(cross_x - 5*mm, cross_y - 15*mm, 10*mm, 30*mm, fill=1, stroke=0) # Title c.setFillColor(colors.white) c.setFont('Helvetica-Bold', 32) c.drawString(30*mm, H - 90*mm, 'ANAESTHESIA') c.setFont('Helvetica-Bold', 28) c.drawString(30*mm, H - 105*mm, 'QUICK REVISION NOTES') # Divider line c.setStrokeColor(colors.HexColor('#1B9AAA')) c.setLineWidth(2) c.line(30*mm, H - 115*mm, W - 25*mm, H - 115*mm) # Subtitle c.setFillColor(colors.HexColor('#A8DADC')) c.setFont('Helvetica', 14) c.drawString(30*mm, H - 130*mm, 'Topics Covered:') topics = [ u'\u2022 Thiopentone | BBB Cross | Day Care Anaesthesia', u'\u2022 Malignant Hyperthermia | CNS Protectives', u'\u2022 Local & Regional Anaesthesia', u'\u2022 General Anaesthesia | Inhalational Agents', u'\u2022 Muscle Relaxants | NMB Reversal', u'\u2022 Airway Management | CPR | Ventilation', u'\u2022 MIS Relaxants | O\u2082 Delivery Devices', ] c.setFillColor(colors.HexColor('#E0E0E0')) c.setFont('Helvetica', 11) y_pos = H - 148*mm for t in topics: c.drawString(35*mm, y_pos, t) y_pos -= 9*mm # Page count info c.setFillColor(colors.HexColor('#A8DADC')) c.setFont('Helvetica', 10) c.drawString(30*mm, 35*mm, '4 Pages of Handwritten Notes') # Date c.setFillColor(colors.HexColor('#A8DADC')) c.setFont('Helvetica', 10) c.drawRightString(W - 25*mm, 35*mm, 'Date: 28 July 2026') c.showPage() # ── NOTE PAGES ────────────────────────────────────────────────────────────── page_titles = [ 'Page 1 - Thiopentone | Day Care Anaesthesia | Malignant Hyperthermia', 'Page 2 - Local/Regional Anaesthesia | General Anaesthesia | Inhalational Agents', 'Page 3 - Muscle Relaxants | Ventilation | MIS Relaxants', 'Page 4 - Airway Management | CPR | O2 Delivery Devices', ] header_h = 18*mm footer_h = 10*mm margin = 6*mm for i, (img_path, title) in enumerate(zip(page_images, page_titles)): # white background c.setFillColor(colors.white) c.rect(0, 0, W, H, fill=1, stroke=0) # Header bar c.setFillColor(colors.HexColor('#0D1B2A')) c.rect(0, H - header_h, W, header_h, fill=1, stroke=0) # Left accent in header c.setFillColor(colors.HexColor('#EF476F')) c.rect(0, H - header_h, 6*mm, header_h, fill=1, stroke=0) # Header text c.setFillColor(colors.white) c.setFont('Helvetica-Bold', 9) c.drawString(10*mm, H - header_h + 6*mm, 'ANAESTHESIA NOTES') c.setFont('Helvetica', 8) c.drawRightString(W - 8*mm, H - header_h + 6*mm, title[:70]) # Footer bar c.setFillColor(colors.HexColor('#0D1B2A')) c.rect(0, 0, W, footer_h, fill=1, stroke=0) c.setFillColor(colors.HexColor('#1B9AAA')) c.rect(0, 0, 6*mm, footer_h, fill=1, stroke=0) c.setFillColor(colors.white) c.setFont('Helvetica', 8) c.drawRightString(W - 8*mm, 3*mm, f'Page {i+2} of 5') # Image area img_x = margin img_y = footer_h + margin img_w = W - 2*margin img_h = H - header_h - footer_h - 2*margin # Load PIL image to get aspect ratio pil_img = PILImage.open(img_path) orig_w, orig_h = pil_img.size aspect = orig_h / orig_w # Fit image maintaining aspect ratio if img_h / img_w > aspect: # width limited draw_w = img_w draw_h = img_w * aspect else: # height limited draw_h = img_h draw_w = img_h / aspect # Center the image x_offset = img_x + (img_w - draw_w) / 2 y_offset = img_y + (img_h - draw_h) / 2 c.drawImage(img_path, x_offset, y_offset, width=draw_w, height=draw_h, preserveAspectRatio=True) # Light border around image c.setStrokeColor(colors.HexColor('#1B9AAA')) c.setLineWidth(1) c.rect(x_offset - 1, y_offset - 1, draw_w + 2, draw_h + 2, fill=0, stroke=1) c.showPage() c.save() print(f"PDF created: {output_path}") print(f"Size: {os.path.getsize(output_path) / 1024:.1f} KB") PYEOF

python3 -c " from pypdf import PdfReader r = PdfReader('/tmp/workspace/output/Anaesthesia_Notes_Enhanced.pdf') print(f'Total pages: {len(r.pages)}') for i, p in enumerate(r.pages): print(f' Page {i+1}: {p.mediabox.width:.0f}x{p.mediabox.height:.0f}') "

python3 << 'PYEOF' from docx import Document from docx.shared import Pt, Inches, RGBColor from docx.enum.text import WD_ALIGN_PARAGRAPH from docx.oxml.ns import qn from docx.oxml import OxmlElement import os doc = Document() # ── Page margins from docx.shared import Inches section = doc.sections[0] section.top_margin = Inches(0.8) section.bottom_margin = Inches(0.8) section.left_margin = Inches(1.0) section.right_margin = Inches(1.0) # ── Default Normal style normal = doc.styles['Normal'] normal.font.name = 'Calibri' normal.font.size = Pt(11) # ── Helper functions def heading1(doc, text): p = doc.add_heading(text, level=1) p.runs[0].font.color.rgb = RGBColor(0x0D, 0x1B, 0x2A) return p def heading2(doc, text): p = doc.add_heading(text, level=2) p.runs[0].font.color.rgb = RGBColor(0x1B, 0x9A, 0xAA) return p def bullet(doc, text, level=0): p = doc.add_paragraph(style='List Bullet') p.paragraph_format.left_indent = Inches(0.3 + level * 0.3) run = p.add_run(text) run.font.size = Pt(11) return p def subbullet(doc, text): return bullet(doc, text, level=1) def bold_para(doc, text): p = doc.add_paragraph() run = p.add_run(text) run.bold = True run.font.size = Pt(11) return p def arrow_bullet(doc, label, detail, level=0): """label => detail""" p = doc.add_paragraph() p.paragraph_format.left_indent = Inches(0.3 + level * 0.25) r1 = p.add_run(u'\u2192 ' + label) r1.bold = True r1.font.size = Pt(11) if detail: r2 = p.add_run(' \u2013 ' + detail) r2.font.size = Pt(11) return p def plain(doc, text, indent=0): p = doc.add_paragraph() p.paragraph_format.left_indent = Inches(0.3 + indent * 0.25) p.add_run(text).font.size = Pt(11) return p def note(doc, text): p = doc.add_paragraph() p.paragraph_format.left_indent = Inches(0.5) run = p.add_run(text) run.font.size = Pt(10) run.font.color.rgb = RGBColor(0x60, 0x60, 0x60) return p # ════════════════════════════════════════════════════ # TITLE # ════════════════════════════════════════════════════ title_p = doc.add_heading('ANAESTHESIA – Quick Revision Notes', 0) title_p.alignment = WD_ALIGN_PARAGRAPH.CENTER title_p.runs[0].font.color.rgb = RGBColor(0x0D, 0x1B, 0x2A) doc.add_paragraph() # ════════════════════════════════════════════════════ # PAGE 1 # ════════════════════════════════════════════════════ heading1(doc, 'THIOPENTONE') bullet(doc, 'Highly Lipid Soluble') bullet(doc, 'BBB Cross') bullet(doc, 'Rapid onset \u2192 20\u201330 seconds') bullet(doc, 'Duration: Short \u2192 Redistribution') bullet(doc, 'Renal excretion \u2717') bullet(doc, 'Redistribution \u2192 Brain \u2192 Muscle \u2192 Fat') bullet(doc, 'Fat \u2192 Storage reservoir') bullet(doc, 'Cannot be administered in Acute Intermittent Porphyria') doc.add_paragraph() bold_para(doc, 'It activates ALA Synthase \u2193 Porphyrin formation') doc.add_paragraph() plain(doc, '\u2192 Cerebroprotective, \u2193 CSF vol, \u2193 ICP,') plain(doc, ' \u2193 Cerebral Blood Flow & \u2193 Cerebral Blood Volume, Hypotension') plain(doc, '\u2192 Breathing pattern \u2192 SRP \u2192 Breath \u2192 Stop \u2192 Produces Cheyne-Stokes Apnea') doc.add_paragraph() heading2(doc, 'Anaesthesia in Special Cases') p = doc.add_paragraph() p.add_run('1. Best anaesthesia in Pre-eclampsia \u2192 Continue Regional').bold = True plain(doc, ' Reason \u2192 Avoid difficult intubation. Epidural') plain(doc, ' Causeway (edema), Improve Uteroplacental Perfusion, \u2193 Catecholamine') p = doc.add_paragraph() r = p.add_run(' Spinal') r.bold = True p.add_run(' \u2192 Mild pre-eclampsia only (Risk of Hypotension)') p = doc.add_paragraph() r = p.add_run(' GA') r.bold = True p.add_run(' \u2192 Coagulopathy or Severe Complicated Pre-eclampsia') doc.add_paragraph() # ──────────────────────────────────────────────────── heading1(doc, '5) DAY CARE ANAESTHESIA') arrow_bullet(doc, 'Propofol', 'IV Induction Agent of Choice') arrow_bullet(doc, 'Sevoflurane', 'Inhalational Agent of Choice') arrow_bullet(doc, 'Rocuronium', 'Muscle Relaxant') doc.add_paragraph() # ──────────────────────────────────────────────────── heading1(doc, '6) MALIGNANT HYPERTHERMIA') bullet(doc, 'Drugs causing \u2192 Halothane, Isoflurane, Desflurane, Ether, Methoxyflurane') bullet(doc, 'Tx \u2192 Dantrolene') bullet(doc, ' (IV agent) (IV agent)') doc.add_paragraph() heading1(doc, '7) CNS PROTECTIVES') p = doc.add_paragraph() r = p.add_run('CNS Protectives \u2192 ') r.bold = True p.add_run('Thiopentone (IV agent), Propofol (IV agent)') subbullet(doc, 'Isoflurane') subbullet(doc, 'NOT Protect: Ketamine, Lignocaine, Halothane, Desflurane, Enflurane') doc.add_paragraph() p = doc.add_paragraph() r = p.add_run('CVS Protect \u2192 ') r.bold = True p.add_run('Etomidate, Ketamine, Vecuronium, Pancuronium, Isoflurane, Desflurane') doc.add_paragraph() p = doc.add_paragraph() r = p.add_run('\u2192 K-protect \u2192 ') r.bold = True p.add_run('Bupivacaine, Propofol, Thiopentone, Halothane, Suxamethonium') doc.add_paragraph() # ════════════════════════════════════════════════════ # PAGE 2 # ════════════════════════════════════════════════════ heading1(doc, 'LOCAL & REGIONAL ANAESTHESIA') p = doc.add_paragraph() r = p.add_run('EMLA \u2192 ') r.bold = True p.add_run('Prilocaine & Lignocaine + Methemoglobin') doc.add_paragraph() heading2(doc, '2) Epinephrine / Adrenaline') bullet(doc, 'Most susceptible \u2192 B-fiber') bullet(doc, 'Least susceptible \u2192 C-fiber') bullet(doc, 'B > A\u03b4 > A\u03b3 > AB > A\u03b1 > C') doc.add_paragraph() heading2(doc, '3) Proparacaine \u2192 Topical Ocular Local Anaesthesia') bullet(doc, 'Onset: Very rapid (20\u201330 seconds)') bullet(doc, 'Duration \u2192 10\u201325 min') bullet(doc, 'CI \u2192 Hypersensitivity') bullet(doc, 'Uses \u2192 Tonometry, Gonioscopy, Corneal foreign body removal, Short ophthalmic procedures') doc.add_paragraph() heading2(doc, '4) Duration') bullet(doc, 'Short \u2192 Procaine + Chloroprocaine') bullet(doc, 'Intermediate \u2192 Lidocaine, Mepivacaine, Prilocaine') bullet(doc, 'Long-acting \u2192 Tetracaine, Bupivacaine, Ropivacaine, Etidocaine') doc.add_paragraph() arrow_bullet(doc, 'Cocaine', 'Natural Vasoconstrictor, 1st LA, HTN') arrow_bullet(doc, 'Chlorprocaine', 'Intradural CI \u2192 Paraplegia') arrow_bullet(doc, 'Prilocaine', 'Safest, Max. Methemoglobin, Bier block, EMLA') arrow_bullet(doc, 'Procaine', 'First Synthetic, DOC for Malignant Hyperthermia, PABA allergy, Safe Anaphylactic Reaction') arrow_bullet(doc, 'Bupivacaine', 'Most Cardiotoxic') plain(doc, ' Toxicity Tx \u2192 Amiodarone, Bretylium (for VT), Vasopressin (for circulatory collapse), Isoflurane, Benzodiazepine (Sedation)') doc.add_paragraph() heading2(doc, '5) LA Commonly Used \u2192 Lidocaine / Lignocaine (most)') bullet(doc, 'Mepivacaine, Chloroprocaine, Procaine, Lignocaine / Etidocaine') doc.add_paragraph() # ──────────────────────────────────────────────────── heading1(doc, 'GENERAL ANAESTHESIA') heading2(doc, '1) Etomidate') bullet(doc, 'Heart Pt. \u2013 Cause Adrenal Suppression') bullet(doc, 'Dissociative anaesthesia') bullet(doc, 'Ketamine \u2192 Asthma / Bronchospasm') subbullet(doc, 'Pain killer, Vivid dreams, Hallucinations') bullet(doc, 'Propofol \u2192 Rapid, Smooth recovery, CV depression') bullet(doc, 'Thiopentone \u2192 Brain Sleep, Sedation & Hypnosis') doc.add_paragraph() heading2(doc, '2) Desflurane \u2192 Pungent Smell') bullet(doc, 'Irritate Airway') bullet(doc, 'Laryngospasm') bullet(doc, 'Not used in Induction, especially in children') doc.add_paragraph() heading2(doc, '3) Sevoflurane') bullet(doc, 'Safe for Induction') bullet(doc, 'Smooth Endotracheal Intubation') bullet(doc, 'Non-pungent') doc.add_paragraph() heading2(doc, 'MAC \u2261 1 Potency (MAC potency)') plain(doc, 'Halothane > Isoflurane > Enflurane > Sevoflurane > Desflurane > N\u2082O') doc.add_paragraph() heading2(doc, 'SEVO \u2192 Induction, Small kids, Safe Airways (Asthma), Liver & Brain') heading2(doc, 'DES \u2192 Discharge fastest, Elderly + Obese + Kidneys') heading2(doc, 'ISO \u2192 Heart (Cardiac Surgery)') doc.add_paragraph() plain(doc, 'Halothane \u2192 Hepatitis + Heart depression, High Blood Solubility (Slow Induction)') plain(doc, 'Potency \u2192 Methoxyflurane > Halothane > Isoflurane + N\u2082O') doc.add_paragraph() # ════════════════════════════════════════════════════ # PAGE 3 # ════════════════════════════════════════════════════ heading1(doc, 'MUSCLE RELAXANTS (MR) / NMB') heading2(doc, 'Properties to Evaluate & Monitor') bullet(doc, 'Ht Pt \u2192 Bisected Sider') doc.add_paragraph() heading2(doc, '1) Side / Breath Effect') plain(doc, 'V | V\u2193 | V\u2193 | (note)') doc.add_paragraph() heading2(doc, '2) Best Progress 2x Half before 2nd') bullet(doc, 'Histamine Stimulate') bullet(doc, 'Glottis Standard (A13 Hz alternators) Monograph') doc.add_paragraph() heading2(doc, 'A) Assist Control Ventilator \u2192 H\u2082 (Forced)') plain(doc, ' H\u2082O\u2082 \u2192 Resist all') doc.add_paragraph() heading2(doc, 'SIMV (Synchronized Intermittent Mandatory Ventilation)') bullet(doc, 'Allows Breathing Mode (11 apnea: Spent breathe Bh: Life km)') bullet(doc, 'PIV (Phase to Bolted Ventilation) \u2192 Pieces Fixed') bullet(doc, 'Tidal Volume variable') bullet(doc, 'Useful in ARDS (Barotrauma risk lower)') doc.add_paragraph() plain(doc, 'CMV (Controlled Mandatory Ventilation) \u2192') plain(doc, ' No effect (Ventilate Solo, breaths done in) used in fully paralyzed / sedated pt') doc.add_paragraph() heading2(doc, '5) Barotrauma \u2192 Pressure (1 atm) \u2192 Heard as P no \u2192 Cautions as more danger') doc.add_paragraph() heading2(doc, '6) Pressure \u2192 Dangerous forms (Avoid)') bullet(doc, 'Refer \u2192 2-3 factors (less fluid at 24 hrs)') bullet(doc, 'Patient with 24 hrs') bullet(doc, 'Solid & Organic at 6 hrs') bullet(doc, 'Others: above fasting for clear fluids or 2 hrs; light meal \u2192 6 hrs; want: cooked Dry Fried, Fatty food or Khirs \u2192 Maharaja Injection') doc.add_paragraph() # RIGHT SIDE page 3 ───────────────────────────────── heading1(doc, 'MIS RELAXANTS (NMB)') heading2(doc, '1) Depolarizing MR (Relaxant) \u2192 Succinylcholine choice') bullet(doc, 'NDMR \u2192 Ultrashort & Contraindication') bullet(doc, 'Short \u2192 Mivacurium') bullet(doc, 'Intermediate \u2192 Atracurium') subbullet(doc, 'Cisatracurium (safer)') subbullet(doc, 'Vecuronium 4th generation') subbullet(doc, 'Rocuronium') bullet(doc, 'Long \u2192 Pancuronium') subbullet(doc, 'Doxacuronium') subbullet(doc, 'Pipecuronium') bullet(doc, 'NDMR \u2192 Reverse MR relaxant') plain(doc, ' \u2193 Neostigmine (AChE \u2400)') plain(doc, ' \u2193 TAch') plain(doc, ' \u2193 NMJ contraction') doc.add_paragraph() heading2(doc, '2) Vecuronium / Rocuronium Reversal') bullet(doc, 'Sugammadex') bullet(doc, 'Use: Modified 7-cyclodextrin') bullet(doc, 'Mechanism: Encapsulate drug, Inactive') bullet(doc, 'Excretion \u2192 Renal & also neuromuscular') doc.add_paragraph() heading2(doc, '3) Glycopyrrolate \u2192 IHB, Belch, Bronchitis, Bronchospasm, dilataion') bullet(doc, 'But NOT act on Neuromuscular Junction') doc.add_paragraph() heading2(doc, '4) Halothane + Suxamethonium \u2192') bullet(doc, 'Malignant Hyperthermia Trigger') bullet(doc, 'Is a Dantrolene (CCB)') bullet(doc, 'Dantrolene \u2192 46/72 mutation \u2192 Treat \u2192 Continuous NMJ blockade') bullet(doc, '\u2192 SAFE use \u2192 HEAT \u2192 Malignant Hyperthermia') bullet(doc, 'Safe MR only on Rvco, Vecuronium (contra: Hyperthermia)') doc.add_paragraph() # ════════════════════════════════════════════════════ # PAGE 4 # ════════════════════════════════════════════════════ heading1(doc, 'AIRWAY MANAGEMENT & RESOURCES') heading2(doc, '1) Spont Ventilation \u2192 A > 0 GE > CB') bullet(doc, 'Larks n \u2192 DFE > BC > A') plain(doc, 'A = Magills') plain(doc, 'C = Waters to & fro') plain(doc, 'D = Bain Circuit') plain(doc, 'E = Ayres t-Piece') plain(doc, 'F = Jackson Rees modified (Connectors of Ayres T-tube) \u2192 Used in Paediatric Anaesthesia') doc.add_paragraph() heading2(doc, '2) Post Intubation Subglottic Stenosis') p = doc.add_paragraph() r = p.add_run('Symptoms \u2192 ') r.bold = True p.add_run('Stridor, Dyspnea, Voice Change, Hoarseness, Severe case Resp. distress') arrow_bullet(doc, 'Tx', 'Laryngoscopy / Bronchoscopy + CT / MRI') plain(doc, 'Grading = L-Hour Meyer grading') arrow_bullet(doc, 'Mild', 'Endoscopic Balloon dilatation / Mechanical dilatation') arrow_bullet(doc, 'Mod', 'Laser therapy + Dilatation') arrow_bullet(doc, 'Severe', 'Surgical Resection') doc.add_paragraph() heading2(doc, '3) High Quality CPR for Adults') bullet(doc, 'Push Hard = 5\u20136 cm depth') bullet(doc, 'Push fast = 100\u2013120/min frequency') bullet(doc, 'Allow for complete chest recoil') bullet(doc, 'Minimize interruption in compress <10 sec') bullet(doc, 'Avoid excessive ventilation') bullet(doc, 'Rotate compressor every 2 min or earlier if fatigue') bullet(doc, 'If no advanced airway: 30:2 compression ventilation ratio') plain(doc, '\u2192 Attempt to improve CPR quality \u2192') plain(doc, ' Quantitative Waveform Capnograph \u2192 PETCO\u2082 clounting Hg') plain(doc, ' Intra arterial pres. \u2192 Diastolic phase (diastolic)') plain(doc, ' Pres. < 20 mm Hg compression') plain(doc, 'Child \u2192 1 rescuer \u2192 30:2; 2 rescuer \u2192 15:1') doc.add_paragraph() heading2(doc, '4) For cannulation or newborn \u2192 24G needle, 5ml Syringe, Adhesive tape, 6(5) Saline') doc.add_paragraph() heading2(doc, '5) NRBM = FiO\u2082 \u2192 80\u201385% (Highest in Conventional O\u2082 Therapy)') bullet(doc, 'Uses \u2192 Severe Hypoxia') bullet(doc, '\u2192 Trauma') bullet(doc, '\u2192 CO Poisoning') plain(doc, 'Venturi Mask \u2192 Principle \u2192 Bernoulli Principle (colour valve is)') plain(doc, 'Uses \u2192 COPD \u2192 0.24\u20130.60 FiO\u2082 maintain') plain(doc, 'Hudson \u2192 Type = Low flow, Variable Performance device') plain(doc, ' Uses \u2192 Short term O\u2082 therapy') doc.add_paragraph() heading2(doc, '6) Rapid Sequence Intubation \u2192 Preoxygenate \u2265 100%') bullet(doc, 'O\u2082 for 2\u20133 min') bullet(doc, 'Give Induction agent') bullet(doc, 'Immediately give muscle relaxant (Succinylcholine / Rocuronium)') bullet(doc, 'No bag-mask ventilate') bullet(doc, 'Intubate \u2265 high vol, low press cuff') doc.add_paragraph() heading2(doc, '7) Children \u2192 FiO\u2082 \u2265 30% (\u226421%) + nasal cannula flow in L/min x 4') bullet(doc, 'Low flow device \u2192 Nasal Cannula, Face mask, Face tent, Non-rebreather mask') bullet(doc, 'High flow \u2192 Venturi mask, High flow nasal cannula, Mechanical ventilation') doc.add_paragraph() heading2(doc, '8) Ambu \u2192 2nd gen. Supraglottic Airway') plain(doc, 'Present \u2192 2nd generation') doc.add_paragraph() heading2(doc, '9) Drugs ACLS \u2192 Epi/Adrenaline') bullet(doc, 'Amiodarone') bullet(doc, 'Lignocaine') bullet(doc, 'AEO') bullet(doc, 'Defibrillator') bullet(doc, 'MgSO\u2084 \u2192 Torsade de Pointes & Hyponaemia') doc.add_paragraph() # Footer note doc.add_paragraph() p = doc.add_paragraph() p.alignment = WD_ALIGN_PARAGRAPH.CENTER run = p.add_run('- End of Notes - Anaesthesia Quick Revision -') run.font.size = Pt(9) run.font.color.rgb = RGBColor(0x99, 0x99, 0x99) run.italic = True os.makedirs('/tmp/workspace/output', exist_ok=True) out = '/tmp/workspace/output/Anaesthesia_Notes.docx' doc.save(out) print("Saved:", out) import os print("Size:", os.path.getsize(out), "bytes") PYEOF

python3 -c " from docx import Document doc = Document('/tmp/workspace/output/Anaesthesia_Notes.docx') paras = [p.text for p in doc.paragraphs if p.text.strip()] print(f'Total paragraphs with text: {len(paras)}') print('First 10:') for p in paras[:10]: print(' ', p[:80]) print('Last 5:') for p in paras[-5:]: print(' ', p[:80]) "

python3 << 'PYEOF' from docx import Document from docx.shared import Pt, Inches, RGBColor, Cm from docx.enum.text import WD_ALIGN_PARAGRAPH from docx.oxml.ns import qn from docx.oxml import OxmlElement import os doc = Document() # ── Page setup section = doc.sections[0] section.top_margin = Cm(1.8) section.bottom_margin = Cm(1.8) section.left_margin = Cm(2.0) section.right_margin = Cm(2.0) # ── Default Normal style normal = doc.styles['Normal'] normal.font.name = 'Calibri' normal.font.size = Pt(11) # Colors NAVY = RGBColor(0x0D, 0x1B, 0x2A) TEAL = RGBColor(0x00, 0x7A, 0x8A) RED = RGBColor(0xC0, 0x20, 0x20) DARK = RGBColor(0x22, 0x22, 0x22) GREY = RGBColor(0x55, 0x55, 0x55) GREEN = RGBColor(0x1A, 0x7A, 0x1A) PURPLE = RGBColor(0x60, 0x00, 0x90) # ── Helpers def h1(doc, text): p = doc.add_heading('', level=1) p.clear() run = p.add_run(text) run.font.name = 'Calibri' run.font.size = Pt(14) run.font.bold = True run.font.color.rgb = NAVY run.font.underline = True return p def h2(doc, text): p = doc.add_heading('', level=2) p.clear() run = p.add_run(text) run.font.name = 'Calibri' run.font.size = Pt(12) run.font.bold = True run.font.color.rgb = TEAL return p def h3(doc, text): p = doc.add_paragraph() run = p.add_run(text) run.font.name = 'Calibri' run.font.size = Pt(11) run.font.bold = True run.font.color.rgb = RED return p def bp(doc, text, level=0, color=None): """Bullet point""" p = doc.add_paragraph() p.paragraph_format.left_indent = Cm(0.5 + level * 0.6) p.paragraph_format.space_before = Pt(1) p.paragraph_format.space_after = Pt(1) run = p.add_run(u'\u2022 ' + text) run.font.name = 'Calibri' run.font.size = Pt(11) if color: run.font.color.rgb = color return p def sub(doc, text, color=None): return bp(doc, text, level=1, color=color) def arr(doc, key, val='', key_color=None, val_color=None): """key => val""" p = doc.add_paragraph() p.paragraph_format.left_indent = Cm(0.5) p.paragraph_format.space_before = Pt(1) p.paragraph_format.space_after = Pt(1) r1 = p.add_run(u'\u2192 ') r1.font.name = 'Calibri'; r1.font.size = Pt(11) r2 = p.add_run(key) r2.font.name = 'Calibri'; r2.font.size = Pt(11); r2.font.bold = True if key_color: r2.font.color.rgb = key_color if val: r3 = p.add_run(' \u2013 ' + val) r3.font.name = 'Calibri'; r3.font.size = Pt(11) if val_color: r3.font.color.rgb = val_color return p def sub_arr(doc, key, val=''): p = doc.add_paragraph() p.paragraph_format.left_indent = Cm(1.1) p.paragraph_format.space_before = Pt(1) p.paragraph_format.space_after = Pt(1) r1 = p.add_run(u'\u21b3 ') r1.font.name = 'Calibri'; r1.font.size = Pt(11); r1.font.color.rgb = TEAL r2 = p.add_run(key) r2.font.name = 'Calibri'; r2.font.size = Pt(11); r2.font.bold = True if val: r3 = p.add_run(' \u2013 ' + val) r3.font.name = 'Calibri'; r3.font.size = Pt(11) return p def kv(doc, key, val, indent=0): """bold key: normal val""" p = doc.add_paragraph() p.paragraph_format.left_indent = Cm(0.5 + indent * 0.6) p.paragraph_format.space_before = Pt(1) p.paragraph_format.space_after = Pt(1) r1 = p.add_run(key + ': ') r1.font.bold = True; r1.font.name = 'Calibri'; r1.font.size = Pt(11) r2 = p.add_run(val) r2.font.name = 'Calibri'; r2.font.size = Pt(11) return p def plain(doc, text, indent=0, bold=False, color=None): p = doc.add_paragraph() p.paragraph_format.left_indent = Cm(0.5 + indent * 0.6) p.paragraph_format.space_before = Pt(1) p.paragraph_format.space_after = Pt(1) run = p.add_run(text) run.font.name = 'Calibri'; run.font.size = Pt(11) run.font.bold = bold if color: run.font.color.rgb = color return p def sp(doc): p = doc.add_paragraph() p.paragraph_format.space_before = Pt(2) p.paragraph_format.space_after = Pt(2) return p def divider(doc): p = doc.add_paragraph() pPr = p._p.get_or_add_pPr() pBdr = OxmlElement('w:pBdr') bottom = OxmlElement('w:bottom') bottom.set(qn('w:val'), 'single') bottom.set(qn('w:sz'), '4') bottom.set(qn('w:space'), '1') bottom.set(qn('w:color'), '007A8A') pBdr.append(bottom) pPr.append(pBdr) return p # ════════════════════════════════════════════════════════════════════ # TITLE PAGE # ════════════════════════════════════════════════════════════════════ p = doc.add_paragraph() p.alignment = WD_ALIGN_PARAGRAPH.CENTER run = p.add_run('ANAESTHESIA') run.font.name = 'Calibri'; run.font.size = Pt(28); run.font.bold = True; run.font.color.rgb = NAVY p = doc.add_paragraph() p.alignment = WD_ALIGN_PARAGRAPH.CENTER run = p.add_run('Quick Revision Notes') run.font.name = 'Calibri'; run.font.size = Pt(16); run.font.color.rgb = TEAL; run.font.italic = True divider(doc) sp(doc) # ════════════════════════════════════════════════════════════════════ # ───────────────────────── PAGE 1 ────────────────────────────────── # ════════════════════════════════════════════════════════════════════ # ── THIOPENTONE h1(doc, 'THIOPENTONE') bp(doc, 'Highly Lipid Soluble') arr(doc, 'BBB Cross') kv(doc, 'Rapid onset', '20 \u2013 30 seconds') kv(doc, 'Duration', 'Short \u2192 due to Redistribution (NOT metabolism)') bp(doc, 'Renal Excretion \u2717 (does NOT undergo renal excretion)') arr(doc, 'Redistribution', 'Brain \u2192 Muscle \u2192 Fat') arr(doc, 'Fat', 'Storage reservoir') bp(doc, 'Cannot be administered in Acute Intermittent Porphyria (AIP)') sub(doc, 'It activates ALA Synthase \u2191 Porphyrin formation') sp(doc) h3(doc, 'Properties:') arr(doc, 'Cerebroprotective') sub_arr(doc, '\u2193 CSF vol, \u2193 ICP') sub_arr(doc, '\u2193 Cerebral Blood Flow & \u2193 Cerebral Blood Volume') sub_arr(doc, 'Hypotension') arr(doc, 'Breathing pattern', 'SRP \u2192 Breath \u2192 Stop \u2192 Produces Cheyne-Stokes / Apnea') sp(doc) divider(doc) # ── ANAESTHESIA IN SPECIAL CASES h1(doc, 'ANAESTHESIA IN SPECIAL CASES') h2(doc, '1) Best Anaesthesia in Pre-eclampsia \u2192 CONTINUE REGIONAL (Epidural)') bp(doc, 'Reason \u2192 Avoid difficult intubation') bp(doc, 'Causeway Edema \u2192 Improve Uteroplacental Perfusion, \u2193 Catecholamine') sp(doc) arr(doc, 'Spinal', 'Mild pre-eclampsia ONLY (Risk of Hypotension)', key_color=GREEN) arr(doc, 'GA', 'Coagulopathy or Severe Complicated Pre-eclampsia', key_color=RED) sp(doc) divider(doc) # ── DAY CARE ANAESTHESIA h1(doc, '5) DAY CARE ANAESTHESIA') arr(doc, 'Propofol', 'IV Induction Agent of Choice') arr(doc, 'Sevoflurane', 'Inhalational Agent of Choice') arr(doc, 'Rocuronium', 'Muscle Relaxant') sp(doc) divider(doc) # ── MALIGNANT HYPERTHERMIA h1(doc, '6) MALIGNANT HYPERTHERMIA') h3(doc, 'Drugs Causing Malignant Hyperthermia:') bp(doc, 'Halothane') bp(doc, 'Isoflurane') bp(doc, 'Desflurane') bp(doc, 'Ether') bp(doc, 'Methoxyflurane') sp(doc) arr(doc, 'Tx (Treatment)', 'Dantrolene') sub_arr(doc, '(IV agent) + (IV agent means: also Propofol as alternative)') sp(doc) divider(doc) # ── CNS PROTECTIVES h1(doc, '7) CNS PROTECTIVES') h3(doc, 'CNS Protect:') arr(doc, 'Thiopentone', '(IV agent)', key_color=GREEN) arr(doc, 'Propofol', '(IV agent)', key_color=GREEN) arr(doc, 'Isoflurane', key_color=GREEN) sp(doc) h3(doc, 'NOT Protect CNS:') arr(doc, 'Ketamine', key_color=RED) arr(doc, 'Lignocaine', key_color=RED) arr(doc, 'Halothane', key_color=RED) arr(doc, 'Desflurane', key_color=RED) arr(doc, 'Enflurane', key_color=RED) sp(doc) h3(doc, 'CVS Protect:') arr(doc, 'Etomidate', key_color=GREEN) arr(doc, 'Ketamine', key_color=GREEN) arr(doc, 'Vecuronium', key_color=GREEN) arr(doc, 'Pancuronium', key_color=GREEN) arr(doc, 'Isoflurane', key_color=GREEN) arr(doc, 'Desflurane', key_color=GREEN) sp(doc) h3(doc, 'K-protect (Kidney Protect):') arr(doc, 'Bupivacaine', key_color=GREEN) arr(doc, 'Propofol', key_color=GREEN) arr(doc, 'Thiopentone', key_color=GREEN) arr(doc, 'Halothane', key_color=GREEN) arr(doc, 'Suxamethonium', key_color=GREEN) sp(doc) divider(doc) # ════════════════════════════════════════════════════════════════════ # ───────────────────────── PAGE 2 ────────────────────────────────── # ════════════════════════════════════════════════════════════════════ h1(doc, 'LOCAL & REGIONAL ANAESTHESIA') arr(doc, 'EMLA', 'Prilocaine & Lignocaine + Methemoglobin') sp(doc) h2(doc, '2) Epinephrine / Adrenaline (Nerve Fiber Susceptibility)') kv(doc, 'Most susceptible', 'B-fiber') kv(doc, 'Least susceptible', 'C-fiber') plain(doc, 'Order: B > A\u03b4 > A\u03b3 > AB > A\u03b1 > C', bold=True, color=NAVY) sp(doc) h2(doc, '3) Proparacaine \u2192 Topical Ocular Local Anaesthesia') kv(doc, 'Onset', 'Very rapid (20\u201330 seconds)') kv(doc, 'Duration', '10\u201325 min') kv(doc, 'CI', 'Hypersensitivity') kv(doc, 'Uses', 'Tonometry, Gonioscopy, Corneal foreign body removal, Short ophthalmic procedures') sp(doc) h2(doc, '4) Duration of Local Anaesthetics') arr(doc, 'Short acting', 'Procaine + Chloroprocaine') arr(doc, 'Intermediate', 'Lidocaine, Mepivacaine, Prilocaine') arr(doc, 'Long acting', 'Tetracaine, Bupivacaine, Ropivacaine, Etidocaine') sp(doc) h3(doc, 'Individual Drug Notes:') arr(doc, 'Cocaine', 'Natural Vasoconstrictor, 1st LA, causes HTN', key_color=NAVY) arr(doc, 'Chloroprocaine', 'Intradural CI \u2192 Paraplegia', key_color=RED) arr(doc, 'Prilocaine', 'Safest, Max. Methemoglobin, Bier block, EMLA', key_color=GREEN) arr(doc, 'Procaine', 'First Synthetic, DOC for Malignant Hyperthermia, PABA allergy, Safe Anaphylactic reaction', key_color=GREEN) arr(doc, 'Bupivacaine', 'Most Cardiotoxic', key_color=RED) sub(doc, 'Toxicity Tx \u2192 Amiodarone, Bretylium (for VT)') sub(doc, 'Vasopressin (for circulatory collapse)') sub(doc, 'Isoflurane & Benzodiazepine (Sedation)') sp(doc) h2(doc, '5) LA Commonly Used (most)') arr(doc, 'Lidocaine / Lignocaine', 'Most commonly used') bp(doc, 'Also: Mepivacaine, Chloroprocaine, Procaine, Lignocaine / Etidocaine') sp(doc) divider(doc) # ── GENERAL ANAESTHESIA h1(doc, 'GENERAL ANAESTHESIA') h2(doc, '1) Etomidate') bp(doc, 'Heart Pt. \u2013 Causes Adrenal Suppression') bp(doc, 'Dissociative anaesthesia') sp(doc) h2(doc, 'Ketamine \u2192 (Dissociative Agent)') bp(doc, 'Used in: Asthma / Bronchospasm') sub(doc, 'Pain killer, Vivid dreams, Hallucinations') sp(doc) h2(doc, 'Propofol') bp(doc, 'Rapid, smooth recovery, CV depression') sp(doc) h2(doc, 'Thiopentone') bp(doc, 'Brain Sleep \u2013 Sedation & Hypnosis') sp(doc) h2(doc, '2) Desflurane \u2192 Pungent Smell') bp(doc, 'Irritates Airway') bp(doc, 'Causes Laryngospasm') bp(doc, 'NOT used in Induction, especially in children') sp(doc) h2(doc, '3) Sevoflurane') bp(doc, 'Safe for Induction') bp(doc, 'Smooth Endotracheal Intubation') bp(doc, 'Non-pungent') sp(doc) h2(doc, 'MAC \u2261 1 Potency (Potency Order: MAC \u221d 1/Potency)') plain(doc, 'Halothane > Isoflurane > Enflurane > Sevoflurane > Desflurane > N\u2082O', bold=True, color=NAVY) sp(doc) h3(doc, 'Mnemonics / Key Points:') arr(doc, 'SEVO', 'Induction, Small Kids, Safe Airways (Asthma), Liver & Brain', key_color=GREEN) arr(doc, 'DES', 'Discharge fastest, Elderly + Obese + Kidneys', key_color=TEAL) arr(doc, 'ISO', 'Heart (Cardiac Surgery)', key_color=TEAL) arr(doc, 'Halothane', 'Hepatitis + Heart Depression, High Blood Solubility (Slow Induction)', key_color=RED) sp(doc) plain(doc, 'Potency: Methoxyflurane > Halothane > Isoflurane > N\u2082O', bold=True, color=PURPLE) sp(doc) divider(doc) # ════════════════════════════════════════════════════════════════════ # ───────────────────────── PAGE 3 ────────────────────────────────── # ════════════════════════════════════════════════════════════════════ h1(doc, 'MUSCLE RELAXANTS (MR) / NMB') plain(doc, 'Parameters to Evaluate & Monitor', bold=True) sp(doc) h2(doc, '1) Side / Breath Effect') plain(doc, '\u2191V | \u2193V | \u2193V | (note: waveform pattern of tidal volume)') sp(doc) h2(doc, '2) Best Progress \u2013 2x Half before 2nd dose') bp(doc, 'Histamine Stimulate') bp(doc, 'Glottis Standard (A13 Hz alternators) Monograph') sp(doc) h2(doc, 'Modes of Ventilation:') h3(doc, 'A) Assist Control Ventilation (ACV)') bp(doc, 'H\u2082O\u2082 \u2192 Resist All') bp(doc, 'Patient triggers \u2192 Machine gives full breath each time') sp(doc) h3(doc, 'SIMV (Synchronized Intermittent Mandatory Ventilation)') bp(doc, 'Allows spontaneous breathing between mandatory breaths') bp(doc, 'PIV (Phase to Bolted Ventilation) \u2192 Pieces fixed, Tidal Volume variable') bp(doc, 'Useful in ARDS (barotrauma risk lower)') sp(doc) h3(doc, 'CMV (Controlled Mandatory Ventilation)') bp(doc, 'No effect of patient effort (ventilates solo, breaths done in)') bp(doc, 'Used in fully paralyzed / sedated patients') sp(doc) h3(doc, '5) Barotrauma \u2192 Pressure (1 atm) \u2192 heard as P \u2192 Caution as more danger') sp(doc) h3(doc, '6) Pressure \u2013 Dangerous forms (Avoid) / Pre-op Fasting:') bp(doc, 'Refer \u2192 2\u20133 factors (less fluid at 24 hrs)') bp(doc, 'Patient with 24 hrs') bp(doc, 'Solid & Organic at 6 hrs') bp(doc, 'Clear fluids \u2013 2 hrs before') bp(doc, 'Light meal \u2013 6 hrs before') bp(doc, 'Cooked dry fried / fatty food / Khirs (heavy meal) \u2192 8+ hrs before \u2192 Maharaja Injection rule') sp(doc) divider(doc) # ── MIS / NMB RELAXANTS (right side page 3) h1(doc, 'MIS RELAXANTS (NMB) \u2013 Classification') h2(doc, '1) Depolarizing MR (Relaxant) \u2192 Succinylcholine (Suxamethonium) \u2013 Choice') arr(doc, 'NDMR', 'Ultra short & Contraindication') arr(doc, 'Short', 'Mivacurium') arr(doc, 'Intermediate', 'Atracurium') sub_arr(doc, 'Cisatracurium (safer)') sub_arr(doc, 'Vecuronium (4th generation)') sub_arr(doc, 'Rocuronium') arr(doc, 'Long', 'Pancuronium') sub_arr(doc, 'Doxacuronium') sub_arr(doc, 'Pipecuronium') sp(doc) h3(doc, 'NDMR \u2192 Reverse MR relaxant via:') plain(doc, '\u2193 Neostigmine (AChE inhibitor)', indent=1) plain(doc, '\u2193 \u2191 ACh at NMJ', indent=1) plain(doc, '\u2193 NMJ contraction restored', indent=1) sp(doc) h2(doc, '2) Vecuronium / Rocuronium Reversal \u2013 Sugammadex') bp(doc, 'Uses: Modified 7-cyclodextrin') bp(doc, 'Mechanism: Encapsulates drug \u2192 Inactive') bp(doc, 'Excretion \u2192 Renal & also neuromuscular') sp(doc) h2(doc, '3) Glycopyrrolate \u2192 IHB, Belching, Bronchitis, Bronchospasm, Dilatation') bp(doc, 'BUT does NOT act on Neuromuscular Junction') sp(doc) h2(doc, '4) Halothane + Suxamethonium \u2192 Malignant Hyperthermia Trigger') arr(doc, 'Treatment', 'Dantrolene (CCB \u2013 Calcium Channel Blocker)') sub(doc, 'Dantrolene \u2192 RYR1 (Ryanodine receptor) mutation \u2192 Treat \u2192 Continuous NMJ blockade reversal') sub(doc, '\u2192 SAFE use \u2192 Heat removed \u2192 Malignant Hyperthermia controlled') bp(doc, 'Safe MR only: Rocuronium, Vecuronium (contra: all volatile agents)') sp(doc) divider(doc) # ════════════════════════════════════════════════════════════════════ # ───────────────────────── PAGE 4 ────────────────────────────────── # ════════════════════════════════════════════════════════════════════ h1(doc, 'AIRWAY MANAGEMENT & RESOURCES') h2(doc, '1) Spontaneous Ventilation \u2192 A > 0GE > CB') plain(doc, 'Larks n \u2192 DFE > BC > A', indent=1) sp(doc) kv(doc, 'A', 'Magills') kv(doc, 'C', "Waters to & fro") kv(doc, 'D', 'Bain Circuit') kv(doc, 'E', "Ayre's t-Piece") kv(doc, 'F', "Jackson Rees modified (Connectors of Ayre's T-tube) \u2192 Used in Paediatric Anaesthesia") sp(doc) h2(doc, '2) Post Intubation Subglottic Stenosis') h3(doc, 'Symptoms:') bp(doc, 'Stridor') bp(doc, 'Dyspnea') bp(doc, 'Voice change') bp(doc, 'Hoarseness') bp(doc, 'Severe case \u2192 Respiratory distress') sp(doc) arr(doc, 'Tx', 'Laryngoscopy / Bronchoscopy + CT/MRI') plain(doc, 'Grading = L-Hour Meyer grading', indent=1) sp(doc) h3(doc, 'Grading & Management:') arr(doc, 'Mild', 'Endoscopic Balloon dilatation / Mechanical dilatation') arr(doc, 'Moderate', 'Laser therapy + Dilatation') arr(doc, 'Severe', 'Surgical Resection') sp(doc) h2(doc, '3) High Quality CPR for Adults') bp(doc, 'Push Hard = 5\u20136 cm depth') bp(doc, 'Push fast = 100\u2013120/min frequency') bp(doc, 'Allow for complete chest recoil') bp(doc, 'Minimize interruption in compression \u2264 10 sec') bp(doc, 'Avoid excessive ventilation') bp(doc, 'Rotate compressor every 2 min or earlier if fatigue') bp(doc, 'If no advanced airway: 30:2 compression:ventilation ratio') sp(doc) plain(doc, '\u2192 Attempt to improve CPR quality:', bold=True) sub(doc, 'Quantitative Waveform Capnograph \u2192 PETCO\u2082 counting Hg') sub(doc, 'Intra-arterial pressure \u2192 Diastolic phase (diastolic)') sub(doc, 'Pressure < 20 mmHg compression') sp(doc) plain(doc, 'Child \u2192 1 rescuer \u2192 30:2 | 2 rescuer \u2192 15:1', bold=True, color=RED) sp(doc) h2(doc, '4) For Cannulation / Newborn') plain(doc, '24G needle, 5ml Syringe, Adhesive tape, 6(5) Saline') sp(doc) h2(doc, '5) NRBM = Non-Rebreather Mask') arr(doc, 'FiO\u2082', '80\u201385% (Highest in Conventional O\u2082 Therapy)') arr(doc, 'FiO\u2082 range', '0.50\u20131.00') sp(doc) h3(doc, 'Uses:') bp(doc, 'Severe Hypoxia') bp(doc, 'Trauma') bp(doc, 'CO Poisoning') sp(doc) arr(doc, 'Venturi Mask', 'Principle \u2192 Bernoulli Principle (colour valve is the key)') sub(doc, 'Uses \u2192 COPD \u2192 0.24\u20130.60 FiO\u2082 maintain') arr(doc, 'Hudson Mask', 'Type = Low flow, Variable Performance device') sub(doc, 'Uses \u2192 Short term O\u2082 therapy') sp(doc) h2(doc, '6) Rapid Sequence Intubation (RSI)') arr(doc, 'Preoxygenate', '\u2265 100%, O\u2082 for 2\u20133 min') arr(doc, 'Give induction agent') arr(doc, 'Immediately give muscle relaxant', 'Succinylcholine / Rocuronium') arr(doc, 'No bag-mask ventilate') arr(doc, 'Intubate', '\u2265 High vol, low press cuff') sp(doc) h2(doc, '7) Children \u2192 O\u2082 Delivery') arr(doc, 'FiO\u2082', '\u2265 30% (\u226421%) + Nasal Cannula flow in L/min x 4') sp(doc) h3(doc, 'Low Flow Devices:') bp(doc, 'Nasal Cannula') bp(doc, 'Face mask') bp(doc, 'Face tent') bp(doc, 'Non-rebreather mask') sp(doc) h3(doc, 'High Flow:') bp(doc, 'Venturi mask') bp(doc, 'High flow nasal cannula') bp(doc, 'Mechanical ventilation') sp(doc) h2(doc, '8) Ambu \u2192 2nd Generation Supraglottic Airway') plain(doc, 'Present \u2192 2nd generation') sp(doc) h2(doc, '9) Drugs ACLS \u2192') arr(doc, 'First line', 'Epi / Adrenaline') arr(doc, 'Amiodarone', key_color=GREEN) arr(doc, 'Lignocaine', key_color=GREEN) arr(doc, 'AEO (Atropine, Epinephrine, O\u2082)', key_color=GREEN) arr(doc, 'Defibrillator', key_color=GREEN) arr(doc, 'MgSO\u2084', 'Torsade de Pointes & Hyponaemia / Hypomagnesaemia', key_color=TEAL) sp(doc) divider(doc) # ── FOOTER p = doc.add_paragraph() p.alignment = WD_ALIGN_PARAGRAPH.CENTER run = p.add_run('~ End of Anaesthesia Quick Revision Notes ~') run.font.size = Pt(9); run.font.italic = True; run.font.color.rgb = RGBColor(0xAA,0xAA,0xAA) os.makedirs('/tmp/workspace/output', exist_ok=True) out = '/tmp/workspace/output/Anaesthesia_Notes_v2.docx' doc.save(out) import os print("Saved:", out) print("Size:", os.path.getsize(out), "bytes") PYEOF

python3 -c " from docx import Document doc = Document('/tmp/workspace/output/Anaesthesia_Notes_v2.docx') paras = [p.text for p in doc.paragraphs if p.text.strip()] print(f'Total paragraphs: {len(paras)}') for p in paras: print(' ', p[:90]) "