anesthesia manager training working with real-time data

Anesthesia Manager Training Working with Real-Time Data

Presentation TitleDate

Objectives

By the end of this module the participant will be able to:Change the Viewing Resolution for the Composite FlowsheetAdd Emergency Data to Anesthesia ManagerAdd Snapshot Data to Anesthesia ManagerManually enter RT dataCopy forward or Delete forward manually entered RT dataEdit RT data and view the audit trail


Real Time Variables: A Detailed Look

Important concepts in Real Time Variables:Real Time Data Interval (data in database)Viewing resolution (number of columns in flowsheet)Editing dataEmergency dataSnapshotManually entered dataValidating dataVariable properties


Real Time Data FlowsheetViewing Resolution

• All monitor and ventilator information will automatically populate the relevant field• Exceptions

are 02, N20 and AIR (they will have to be entered manually)

• Default data interval display resolution is 5 minutes.


Real Time Data FlowsheetChanging the Viewing Resolution

•RTD is being captured every 30 seconds and is stored on the local workstation**

•The screen resolution can be changed at anytime.

•You can view the data in composite flowsheets in many different time resolutions.

•This does NOT effect the interval of data stored in the database or saved to the patient record.


Changing the Viewing Resolution“1 minute”

• Changing the viewing resolution can be accomplished in any of the flowsheets

•Changing the viewing resolution does NOT change the frequency of data collected to the local machine or to the database


Changing the Viewing Resolution“10 minutes”

• Changing the viewing resolution can be accomplished in any of the flowsheets

•Changing the viewing resolution does NOT change the frequency of data collected to the local machine or to the database


Real Time Data FlowsheetData Collected and Stored on the Server

The RTD Interval represents how often data is collected and saved to the database. The default interval is 1 minute.

This is DIFFERENT than how data is captured in real time during the case (every 30”)

Reviewing a record in the future will only display data points at 5 minutes* (even though the user may be viewing results in real time at shorter intervals)

Interval 1 min

*unless user has taken SNAPSHOTS or entered EMERGENCY DATA


To Change the RTD Interval

1. Click on F3 or 2. Click on the Configuration

Menu/Real-Time Data Interval or3. Click on Interval Display4. The Real-Time Data Interval box

will open5. Select a new interval6. Click OK


Why change the RDT Interval ??Want to capture data that will be stored to the database at a more frequent interval• Induction of anesthesia • Initiation of regional anesthesia

Situations where you are expecting rapid changes in hemodynamics

Changing the RTD only changes the capture on a go forward basis, it will not capture retrospectively• We will discuss how to do this later


Data Resolution-What are those blue triangles??

•Time columns: Blue tick marks indicate that there is more data for this time period than is currently shown. Increase the viewing resolution to view this data.


Data Resolution-What are those blue triangles??

Change resolution to 1 minute

Blue triangles disappear


Snapshot

Snapshot inserts a new column of data at the exact time you choose

• Analogous to creating a “mark” on the Datex record

Click on the Configuration Menu/Snapshot or

Click on the Snapshot icon

These columns are saved in the database


Emergency Data

Emergency Data lets you add real time data at a greater resolution than was originally captured….retrospectively!

Click on Configuration/Emergency Data

Click the “Emergency Data” icon

Once added these columns are saved in the database Note**: Emergency Data is stored in the RAM of the local machine for a maximum of 6 hours. If the application is closed, pt transferred or the machine is rebooted…you will lose the data in the buffer


Real Time Variable-Add/Remove Variableeg. Remove N20 and Sevoflurane from the home screen

You may choose to add or remove a variable from the home screen• To clean up unused

parameters• To add parameters you

choose to see

1. Right click on variable to be removed.


Real Time Variable-Add/Remove Variableeg. Remove N20 and Sevoflurane from the home screen

2. Highlight desired variable to

remove

3. HIT “Remove”

4. Hit “OK”


Real Time Variable-Properties

Each real time variable has properties that can be customized

Properties can be viewed by right clicking on the variable label.

Alert and artifact limits can be set from the properties window.


Setting Artifact and Alert Limits

Alert limits can be set for any variable• Exceeding the Alert limits (high or low) will create a red circle

around the variableThis is analogous to setting alarm limits on the Datex Monitor although there is NO audible prompting from Anesthesia Manager

Artifact limits will prohibit the data from being entered in Anesthesia Manager, unless it is between the High and Low artifact limits.• Use this to keep invalid data from being captured

Eg. Electrocautery causes the Heart Rate to read 200Opening an arterial line to air for zeroing (arterial value=0)/flushing blood from arterial line (arterial value=bag pressure level)



Data cell is bordered in

Red when value is above “Alert

Limit”


Not all real time data in the composite flowsheets comes from medical devices. Some must be entered manually. • Eg. Fresh gas flows

Click in the time cell in which you want to enter data.

Manually Entered Real Time Data


Manual Entry of Data

Enter or Delete value (if you want a change to the selected cell only)

Enter>>> or Delete>>> (if you want the action to be repeated in succeeding cells)

Input desired

value for 02


Manual Entry of Data

Enter (selected cell only)

Enter>>>> (action repeated on a go forward basis)


Due to artifact or other reasons, clinicians may need to change real time data values.

An audit trail of the data values appears in the Edit/Review Data window.

Editing Real Time Data

1. Double Click

value in question

2. Real time

properties will be

displayed


Editing Real Time Data

Note: Edited data will appear with a different color (BLUE)

3. New value

entered

4. System registers the change made by the user


Real Time Variables: Exercise

Open Anesthesia Manager and admit a patient to the Standard Anesthesia Template, if not already done.

Change the viewing resolution of a flowsheet.

Edit some RT data that came from a device.

Insert Emergency Data at 30 second resolution for a two minute period.

Take a Snapshot.

Manually enter the FGF rate of oxygen (not being collected from the driver) and use the copy forward function.

Discuss your observations and ask questions!


Questions And Answers

anesthesia manager training working with real-time data

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