Transcript Document

Anesthesia Manager Training
Basic Navigation
Objectives
By the end of this module the participant will be able to:
Use the basic terminology for all parts of the Anesthesia Manager
application
Understand the :
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Main Toolbar
Macro Toolbar
Navigation Menus (flowsheets/demographics)
Adjusting Resolution
Freezing the timeline
Applying Filters
Pull down menus
Presentation Title
Contents
Introduction
Launch/Login
The Home Screen
Main Toolbar
Main Toolbar or Navigation-Demographics
Navigation Bar-Flowsheets
Macro Toolbar
Viewing Options
Pull Down Menus (F)-Function Keys
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Presentation Title
What is Anesthesia Manager?
Anesthesia Manager is a charting application
and data collection engine for:
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automatically and manually collected data
manually entered fluids and medications
It is an application that manages,
integrates
and stores
Vital patient information at the point of care!
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Presentation Title
Where does all the data come from?
Medical devices (through drivers that Picis develops)
HIS systems (Hospital Information Systems)
Laboratory systems (Future Development)
End users
Others?
• Calculations done by Anesthesia Manager
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Presentation Title
Clinical Data in Anesthesia Manager
Real Time Variables
• Ventilator and Monitor data
• MANUALLY entered clinical data
Medications
Fluids (INtake and OUTput)
Laboratory data (Future Development)
Clinical events
Demographic data
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Presentation Title
Launch and Login to Application
OR (civic campus)
Canada789
We are training in the TRAIN environment
• User ID is your Windows Login ID
• Password is Canada123 (case sensitive)
• You will be prompted to change password
Will need to repeat this exercise when in the LIVE environment
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Presentation Title
Census List
The software will open
and default to:
the facility/location you are
working in and
list patients by OR#
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Presentation Title
Census List
1. Highlight the Patient
2. Click “Start Session” to open a
new session for that patient
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Presentation Title
Home Screen: A Good Place to Start!
Anesthesia Manager
automatically opens
to the
“Anesthesia
Summary”
flow sheet
This is our HOME
screen
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Presentation Title
Ottawa Hospital Workstation
Workstations will have a 19”
monitor in portrait mode
• This will allow the display of
considerable data/entry
fields
• Toolbar icons and macros
will appear in a vertical
orientation on the left and
right hand sides of the
screen
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Presentation Title
Home Screen
Anesthesia Summary Flowsheet
The home screen
consists of four
flowsheets:
Gases-Agents-Monitor
Data
Medications
Med Infusions/Fluids
Standard Anesthesia
Monitoring
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Presentation Title
Home Screen
Anesthesia Summary Flowsheet
The home screen consists of
four flowsheets:
Subheading can be turned
ON (organized by type) or
OFF (organized alphabetically)
Gases-Agents-Monitor Data
Medications
• Organized by subheading of
medication
Med Infusions/Fluids
Standard Anesthesia Monitoring
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Presentation Title
Home Screen
Anesthesia Summary Flowsheet
The home screen consists
of four flowsheets:
Gases-Agents-Monitor Data
Medications
Med Infusions/Fluids
• Organized by
Fluids/Infusions “In” and
• Fluids/Infusions “Out”
Standard Anesthesia
Monitoring
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Presentation Title
Home Screen
Anesthesia Summary Flowsheet
The home screen consists of
four flowsheets:
Gases-Agents-Monitor Data
Medications
Med Infusions/Fluids
Standard Anesthesia
Monitoring
• Graphical recording of typical
vital sign parameters
 sBP, dBP, HR, Sp02, ETC02
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Presentation Title
Home Screen
Anesthesia Summary Flowsheet
Seclecting the “Home
Screen” icon will also take
you to the Home Screen
(Anesthesia Summary
Flowsheet).
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Presentation Title
Home Screen
Patient Banner
•Patient
Name
•Sex
•Weight
•Height
•BSA
•Incoming Lab Data
beacon (future
enhancement)
•Medication Allergies
•Other Allergies
•Precautions/Alerts
•BLUE BANNER=ACTIVE Patient
•WHITE BANNER=REMOTE Patient
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Presentation Title
The Tool Bar
The Tool Bar is designed to help users easily access functions most
commonly used
• There are two types of toolbars: MAIN and MACRO
MAIN TOOLBAR
MACRO TOOLBAR
•Designed to assist with the workflow of the case (Start of anesthesia to Transfer/Discharge)
•Will talk about the Macro Toolbar in the “Events” Tutorial
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Presentation Title
Main Toolbar
”Log Off/On”
Log Off-used to stop documenting under your user name
• Eg. End of case, relief, transfer of care
• Real time data continues to be captured on patient
• You will be asked for your credentials when you elect to logoff
Log On-used to start documenting under your user name
• As above
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Presentation Title
Main Toolbar
“Home”
Home
• Takes you back to the “Anesthesia Summary Flowsheet
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Presentation Title
Main Toolbar
“Protocols”
Protocols
• Groups of standard orders (medications (single or
combinations) /infusions) that you can add to the patient chart
at the SAME time.
• Will offer significant time savings
• Protocols are an integral part of this build
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Presentation Title
Main Toolbar
“Protocols”
•Custom built to allow rapid access and addition to the respective area of a flowsheet
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Presentation Title
Main Toolbar
“Protocols”- Eg. Adding drugs from the **Anes Drug Cart
For example, the “Default
Medication Flowsheet” contains
the main drugs from the respective
medication classes used in the vast
majority of cases
If an administered drug is not
present, “Protocols” is a powerful
and timesaving technique to add
what is required
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Other options are also available and
will be discussed.
Presentation Title
Main Toolbar
“Protocols”- Eg. Adding drugs from the **Anes Drug Cart
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In this case, “*Anes-Drug Cart” brings up every drug/fluid not listed in the
default protocol that can be found on our carts in the Operating Room.
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One drug/fluid or mulitple drugs/fluids can be selected simultaneously and
quickly added to the flowsheet
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Presentation Title
Main Toolbar
“Protocols”- Eg. Performing a Spinal Anesthetic
1. Highlight a
protocol option
2. Click on Atropine and
Bupivicaine to select
If you make an error, reclick to
deselect
Atropine and Bupivicaine are
NOT present on the default
medication flowsheet
However, both drugs can be
found on the anesthesia cart
(**Anes-Drug Cart protocol)
3. Hit Add
button
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Presentation Title
Main Toolbar
“Protocols”- Eg. Performing a Spinal Anesthetic
OR alternatively, the drugs can be
selected from the respective
protocols:
*Anes_Regional Spinal
(Bupivicaine) protocol
• Select Bupivicaine x%
*Anes_CVS_Anticholinergics
protocol
• Select Atropine
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Presentation Title
Main Toolbar
“Protocols”- Eg. Performing a Spinal Anesthetic
Atropine and Bupivicaine
now added to the Flowsheet
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Presentation Title
Main Toolbar
“Protocols”-Subspecialty/Unique Events
In addition to Drug Protocols, we have created
Protocols for various subspecialties and unique
problems
Eg. Vascular, Neuro, Obs/Gyn, Trauma, MH, ACLS
• Click on the orders you want added to the flowsheet
• If you want all the orders in a Protocol, hit ADD
without selecting an order
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Presentation Title
Main Toolbar
“Event Log”
Event Log-Adding Events
• This is the way you will enter in all notes related to the procedure
• Events remove the need to “free text”
• Will discuss further in upcoming lecture
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Presentation Title
Main Toolbar
“Device Snapshot”
Device Snapshot
• Manual capture of Real Time Data (RTD) from devices to
obtain all current values at that point in time.
Will discuss further in upcoming lecture
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Presentation Title
Main Toolbar
“Emergency Data”
Insert Emergency Data
• Emergency data is a selection of data points from a temporary
reserve on the local workstation that holds all data device
readings received over the previous six hours.
• Will allow you to retrospectively enter Real Time Data (RTD)
every 30 seconds for a defined period
Will discuss further in upcoming lecture
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Presentation Title
Main Toolbar
“Fluid Balance”
Fluid Balance
• Total intake and output for fluids documented on flowsheets
are displayed graphically in the Fluid Balance window. The
window also shows total volumes for all fluids.
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Presentation Title
Main Toolbar
“Fluid Balance”
The Fluid Balance Window for
anesthesia environments shows
intake and output on a single
pie chart.
•Fluid
Balance Pie
Chart
•Fluid
Balance
Histogram
Hit this icon to see
the “Fluid Balance
Detail”
An accompanying table shows
values for each fluid type.
•Final
Fluid
Balance
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Presentation Title
Main Toolbar
“Medication Summary”
Medication Summary
• Shows all medications that have been documented, including
those administered as drips. This window shows individual and
total doses for the selected viewing period.
• Medications can be sorted alphabetically by medication or
family name, or chronologically by administration time.
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Presentation Title
Total Dose administered
over the current
encounter
Main Toolbar
“Medication Summary”
Data sorted by
“Administration Time”
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Presentation Title
Main Toolbar
“Supervisory Anesthesia Module”
S.A.M. (Supervisory Anesthesia Module)
• An anesthesiologist who supervises anesthesia
residents/fellows may need to document certain events during
the procedure. SAM allows you to log on and enter events and
demographic data while another user is logged on. All of your
entries will be attributed to you.
• When you have finished, the other user can continue working
without having to log on again.
Will discuss further in upcoming lecture
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Presentation Title
Main Toolbar
“Print”
Print
• Allows you to create a paper/electronic record
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Presentation Title
Main Toolbar
“Remote View”
Remote View
• Allows you to enter and modify any type of data for which you
have access rights on a remote workstation (i.e patient in
another location)
Finish/revise/review documentation on a previous patient
You are able to switch between an active patient and remote
viewing on the local workstation
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Presentation Title
Main Toolbar
“Remote View”
White Banner = Remote View
Blue Banner= Active Patient
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Presentation Title
Main Toolbar
“OR Manager”
OR Manager
• Access to the Smart track System
 Can see location of patients in the system
(Preop, OR, PACU, Discharged)
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Presentation Title
Main Toolbar
“Demographics Flowsheet”
Demographics
• Found at bottom of
Navigation Panel
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Presentation Title
Demographics
“Patient Identification”
Should be coming across from OR
Manager/ADT Hospital system
No need to enter any information into
these fields
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Presentation Title
Demographics
“Admit Ht/Wt/BSA/BMI/Blood Type”
As in Preop Manager
• Enter either in metric or imperial
with automatic conversion
 Metric will be printed to Anesthesia
Record
 Blood Type can be left alone
• Hit OK
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Presentation Title
Demographics
“Allergies and Precautions” (Medication Allergies)
2. Pull down menu
3. Enter name of
drug into “Keyword
Search”
4. Highlight
desired result
•As in Preop Manager
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5. Hit
OK
1.Hit New Row
if required
Presentation Title
Demographics
“Allergies and Precautions” (Other Allergies-not drugs)
2. Pull down menu
3. Highlight
desired result
4. Hit OK
1.Hit New Row
if required
•As in Preop Manager
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Presentation Title
Demographics
“Allergies and Precautions” (Precautions)
2. Pull down menu
3. Highlight desired
result
4. Hit OK
•As in Preop Manager
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1.Hit New Row
if required
Presentation Title
Demographics
“ASA Level”
1. Pick appropriate
ASA
2. Hit OK
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Presentation Title
Demographics
“Medical Team”
2. Pull down menu
First Case of the Day
Booked Surgeon should
be automatically populated
by OR Manager
4. Hit OK
• Correct information as
required
Booked Anesthesiologist
should be populated by OR
Manager
• Correct information as
required
All subsequent cases
will require data entry
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1.Hit New Row
if required
3. Highlight
name for
relevant clinical
role
Presentation Title
Demographics
“Procedure(s)”
2. Enter keyword
3. Find now
5. Hit Add
1. Hit
ADD if
required
4. Choose appropriate
procedure
•Booked surgical procedure should be populated by OR Manager
•Revisions, changes or additions will require data entry
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Presentation Title
Demographics Tab
Required Events
Required Events (highlighted if not
completed)
These are events that should be entered (*if
relevant) on EVERY Anesthetic record
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Anesthesia Start (S)
Anesthesia Case Finish Time (F)
QA Indicator
Anesthesia Type
Positioning
Equipment Check
Peripheral IV
Airway Intubation (if applicable)
Functions as a reminder to insure chart is
complete
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Presentation Title
Navigation Panel
The Navigation Panel gives you quick access
to:
Flowsheets
and
Demographics (recently discussed via icon in
Main Toolbar)
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Presentation Title
Gases/Monitor Data Flowsheet
Any variable captured by
the Datex CPU or the
7900 ventilator will be
automatically captured
Exception-Fresh Gas Flows
• Aestiva has manual controls
• These numbers MUST be
entered manually
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Presentation Title
Medications (All) Flowsheet
For documentation of:
all medications
all medication infusions
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Presentation Title
Med Infusions & Fluids Flowsheet
For documentation
of all:
Fluids In (including
medication infusions)
and
Fluids Out
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Lab Results (All) Flowsheet
Future development to capture lab results in real time from
hospital information systems and populate the electronic
anesthesia record.
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Presentation Title
Anesthesia Summary
Home Screen
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Presentation Title
Trends Flowsheet
For display of:
Non invasive trending
(upper graph)
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Sp02
EtC02
HR
NIBP
Resp Rate (from ETC02)
Invasive trending (lower
graph)
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HR
Arterial Line Blood pressure
PA Catheter pressures
CVP
Presentation Title
Invasive Monitoring Flowsheet
For display of:
invasive RTD (upper) and
graphical display of invasive
trending(lower)
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HR
Arterial Line Blood pressure
PA Catheter pressures
CVP
Presentation Title
Vent Settings Flowsheet
For display of:
Basic ventilation
parameters (upper table)
Ventilation and
oxygentation trend (lower
graph)
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Respirations
ETC02
Sp02
Pmax
Presentation Title
Lab Results (Manual Entry) Flowsheet
Any result not automatically
populated by the lab
• Includes POC results
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Presentation Title
Click Box to Continue
to second half of
Presentation
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Presentation Title