Home

Gas Chart - Vanderbilt University Medical Center

1. om Points to remember v If you document two different doses of fluids in the same time box on the grid the amount will appear blue instead of black designating that it is a multiple does for that time period The total fluid amount documented in that time period will be displayed v The time feature for Add Amount works on a 5 minute increment If 5 minutes have not passed since the last documentation of a fluid dose in the same box it will advance one minute v You cannot delete a fluid name from the list only the doses associated with it Meds e To add a drug or drip for documentation click the Meds label on the left of the screen 3 E The Medications form will pop up 80 SEARCH FOR A DRUG To search for a drug enter the first few letters of the name of the drug The list will expand or shrink depending on how much of the drug name you enter You may also filter the drug list by type i e antibiotic narcotic etc Add Medication Drug List enter drug name here Medication Preparation Time Administerd Dose Route Given By Comment ADDING A MEDI CATION To add a medication to the record find the name of the medication you would like to add Choose medication Next choose the m
2. P 120 Delete Dela a E a 122 OB 124 Fetal IO naa 124 Specific Birth nformalloD iia ria 128 Create EC sSectlon Casio 130 SUP inde 133 EMR TAB odian 135 EMERGENCE ETT T III 136 Case DISPO ON aii Cr ir RIEN CRRNENE a ia 137 ATTENDING NOTES 355 sous c cues GE s Cass aa 138 Ez h eum 141 CHECK CASE aia 152 EXIT CASE A A ES 154 Information Management Tree Setting Up Access VUNetID Used for e mail VPIMS Web GasChart A VUNetID is created for you through Human Resources when you are hired or through your Security Manager once you are an employee Epassword Used with VUNetI D for e mail VPIMS Web and GasChart Set up by going to www vanderbilt edu epassword once you have a VUNetI D RACFID Used for CWS machines Starchart Starpanel Access granted through Human Resources when you are hired or through your Security Manager they will request it from the SAMS team RACF Password A password will be given to you when the RACFID is given to you You will have to change it on your first login f you need your password reset the HelpDesk can do that 3 HELP Logging in to GasChart If you are working on a CWS log in using your RACF ID If you can t log in call 3 HELP for information on how to reset your password Click on the VPIMS Applications Icon on the desktop Locate the Gaschart icon and click it to launch the application NOTE If there is a new version available or the application has never been
3. Diagnoses Procedures za Lado Description asennlian Gede LongDescription 295 02 SIMPLE SCHIZOPHRENCHA SIMPLE SCHIZOPHREN E la General Case Information Acct No fete Room WUH3 AR OB Ena ESjomenta Date 03 14 2008 Edt Procedures wegukg Attending Anesthesiologists Residents CHNAs and SHNAs scheduled Attending Po Del Name Stark Time Stop Time SSS Primary Att per Resident Start Time StopTime Note us mg 03 14 0810 29 Note check core EE Pint Repots MENTES C have received a preoperative hand off report including patient identification and status of blood product and medication To delete a diagnosis just double click on the name of the diagnosis you would like to delete in the lower right box 1 249 05 SIMPL SEHIZ OPHREN REMISS q SOR 10 CUICOCOLNODCERANA ACOD Diagnoses Selected NE Code Description x zd LIther L emments Diagnosis Business Rule You must document either a diagnosis or a diagnosis comment 108 Procedure Procedure is pulled from Patient Tracker information If you need to change or add this information click on the Edit Procedure button Vitale Totals Comments i 10 36 Mi Lia Pm TS Code Description i Anes Ready 1295 02 SIMPLE SCH
4. 36 x 099 e Click Accept to have all listed vitals documented on the grid e Click Defer to suspend the set of vitals temporarily e Click the Discard checkbox by each individual parameter to permanently discard it e Click Discard this Set to permanently discard the entire set of vitals If you defer a set of vitals it will be saved at the bottom left of your screen You may retrieve deferred vitals by clicking the orange Auto Vitals box wILd ne sp n m Gas Hem Labs h ALL Bae ELM20 0 Points to remember v If you do not accept each set of vitals as they pop up they will stack on top of one another You will be able to perform the same steps as described above for each set of vitals until you become current 62 AutoYitals Vitals For 01 23 2008 08 54 Any Existing Data Will Be Ovenwritten Discard Group Parameter Value Unts Timestamp 2 2 t N20 2 63 Correcting a Vital Sign on the Upper Grid To correct one vital sign click on the vital symbol you would like to correct from the left panel as in the Manual Chart Vitals Section of this document Vitals Totals Comments Anes Arway Monitors Checklist Q Case Info D Everts Y Delays OB SCIP EMR En elo Y Scale Get Fast 100 tals Filter Puta Resp anes Gas Hem Labs a EE gt Then click on the grid where you want the vital sign to
5. mg Notes Primary Att per Resident StartT ime StepTime Todd Christie 03 14 08 10 29 v C Solo c Add a New Row for Discontinuous Times Send to StarChart b F have received a preoperative hand off report including patient identification and status of blood product and medication KI ase 111 General Case Information The main thing to note here is the entry verification of the Account Number Acct No This field will remain yellow with red label until a valid account number has been entered and verified GasChart will attempt to fill this field automatically from other sources but even if a number is already there you must verify that it is correct To verify that you agree with the number that is already entered here you must click into the yellow field and then exit the field There is no need to type the hyphen when entering the account number Vitals Totals Comments Anes Arway Monitors Checklist Y Case Info Events Delays OB s LE e 1104 5 T bw Diagnoses Procedures Surgeons Code LongDescrption 11012 DEBRIDEMENT OPEN Fx 25574 OPEN TREATMENT BADIA rs aes EN ee E ME e Del Surgeon lio m Code Description Code Description General Case Information AcctNo Haom STESRM 04 RH 04 Comments Comments 0 22 2008 y Times 07 30 10 30 TERR M Edit Procedures weiohttka El
6. Selected Delays Double click to remove delay fram record Stage Category Reason Intraap In Room Comments gf 122 No Delays Occurred If no delays occurred check the white box next to No Delays Occurred Vitals Comments Anes een Monitors Checklist Case Info Events OB SCIP EMR Earlier Case Ran Over Selected Delays Double click to remove delay fram record Category Reason Comments gf You can also add comments in the bottom white comments box at the bottom of the screen If there is a text field where notes can be entered you will see a d icon If you click on this icon you will be directed to the quick comments page If you have saved quick comments you can use those to fill in the text box Or you can just type in the text box without clicking the d icon Business Rule Either the No Delays Occurred box must be checked or there must be a delay documented 123 OB Click on the OB tab to record information about a birth E Case for ITLL Pee CL labe lane 4 ee MEA NE EET TEE L bag Hd EE NE mo hiji HI pm E EX P Edit a Help Environment DE O1 Vitals Totals S Anes Stark m General OB Info C Labor Analgesia Needed Create C Section Case Anes Ready m C Uterine Incision Required gt d CSeaentase Me m m Fetal Gestational Age weeks Closing MS E Comments Qut Of Room TS Specific Birth Information Infant Name APGAR
7. Attending Anesthesiologists Residents CRNAs and 5SHM s a Scheduled Attending Im Del Name Start Time Stop Time Primary Att per Resident Test CRNA 110422408 11 04 Mame StartTime StapTime Mate Attending Test 10 23 08 07 44 Note Check Case Add a Mew How for Discontinuous Times Ready for Attending L have received a preoperative hand off report including patient identification and status of blood product and medication The number has been entered and verified Vitals Totals Comments d Anes Airway Monitors Checklist Case Info Surgeons om 1 Code LongDescrption Del Surgeon Anes Ready B 11012 DEBRIDEMENT OPEN Fx PA E mese J e Closing S General Case Information DressingOn Acct No Q1 0000022 01 23 mcm m STE3 AM 04 T Rom Panes Fish J 2 Comments Comments 10 23 2008 Timez 07 30 10 30 TUTTA Weight kg Attending Anesthesiologists Residents CRNAs and SANA Scheduled Attending 4 Del Name Start Time Stop Time Primary Att per Resident Test CRNA 10 22 08 11 04 Mame StartTime StopT ime j Attending Test 10 23 08 07 44 Diagnoses Procedures Code Description Code Description o CheckCase Case Add a New Row for Discontinuous Times Ready for Attending for Attending L have received a pr
8. Supplemental Procedures Preop Quality Preop W U Comment Diy Description Excellent Good O Far 2 Poor ref Under testing Over testing Replace Preop Alerts Attending Preop Note BEEN E 7 Anes Time 7 Attending Times and Notes Add a New Row for Discontinuous Times Case To Be Taken Over By Stark Time Stop Time Note 1427 entered this note can edit it or delete it 08 31707 03 04 07 E is my attending nate am typing directly into this box Only the person who pissi I 10 12 i ASA Postoperative Note Future Recommendations A He Assigned Case Level O Elective 010203 nos Was Level Appropriate TEE Notes Trainee Yes Ho Exit Attending Notes Current User jy Data Last Refreshed at 09 13 C 10 36 52 Click on this button to enter the TEE form amp TEE Data Entry Pre Post ByPass Select TEE to edit E deren eS Delete Selected TEE Cancel and E xit Clicking on ADD New TEE will create a new TEE with populated default values for the first time only The first TEE is assigned as 1 Pre meaning 1 pre bypass There is only one Pre for every TEE 141 After the first TEE pre bypass is completed additional TEEs may be added Additional TEEs will be designated with the number followed by post meaning post bypass and will be numbered 2 3 4 etcetera When post bypass TEEs are added the values from the pre
9. When you are done entering orders click Done 151 Check Case At the end of a case click the Check Case button to see if you missed documenting on any mandatory fields vitals Comments Totals Anes Airway Monitors Checklist Y Case Info Events Delays OB SCIP EMR a 12 07 ry Diagnoses Procedures Surgeons In R ME 320 1 PNEUMDCOCCAL MENINGI M 61001 SUBDURAL TAP THROUGH M R 13 11 y Oberer Daniel M V EESTI P Dems ise General Case Information 13 11 7 Acct Mo ooooooo00 0000 M Out OF Room J 12 1 5 Room HSC AM 02 Anes Finish Comments Comments Date 02 06 2007 Attending Anesthesiologistz Residents CHNAs and SANA Scheduled Attending Start ime StopTime am o Check Case Ready for Attending Case Complete Summary of Errors and Warnings Case Complete Errors x The following times are required Anes Finish Att Mates Atleast one attending has not entered an Attending Mate Case Info Ma resident signature and case nat marked SOLO Case Warnings The following Case Times have dates that are more than 2 days AFTER the date of surgery 02 06 2007 Anes Start A 06 18 2007 13 07 In Room 06 18 2007 13 07 Anes Ready 05 18 2007 13 11 Incision 06 18 2007 13 11 Closing 06 18 2007 13 11 Dressing On 06 18 2007 13 11 Qut OF Room 06 18 2007 13 11 This case is NOT complete Please correct
10. e o enter a value for a fluid click in the box next to the fluid name e Anew window will pop up The time and date will be displayed If the time and date are incorrect you may change them by using the same process for changing times as was discussed earlier in this document e Enter a dose in the space provided and click OK e A fluid can only be documented after it is added See previous section on how to add a fluid Edit 45 NS with KCL 20 meg ml Del Time Dose La 02 06 2008 07 00 100 45 NS with KCL 20 meq ml Edit 45 NS with KCL 20 meg ml C 0270872008 v February 2008 Sun Mon Tue Wed Thu Fn Sat 27 28 29 30 31 1 2 3 4 5EBM 3 9 10 11 12 13 14 15 16 17 18 19 230 21 22 23 24 25 b zr 28 29 Ae 3 4 5 BE Today 6 11 2008 e To add a secondary fluid amount in the same time frame click in the same box and click Add Amount e Follow the same steps as above for entering the new amount Delete Fluids e To delete a fluid dose click on the fluid you wish to delete in the correct time frame you wish to delete e Click the Del checkbox by the dose you wish to delete e When you are done deleting fluid doses click OK 79 Edit 45 NS with KCL 20 meg ml Del Time 02 06 2008 07 00 Ay DEA 06 2008 07 05 45 NS with KCL 20 meq ml The grid should recalculate and subtract your deletion appropriately 4556 NS with KCL 20 Albumin 25 ml
11. APGAR Bith Weight Time Df Deliver Time O Placental Preop Breaks ar Temp Namel Delivery u 3 T s d EXC d Current User JoshTest Fellow Data Last Refreshed at 13 39 pe 13 4 Fetal Info The Fetal Info portion of the page is for one time documentation of the general OB information This will only be documented once per case i e once despite twins triplets etc The first section is for general OB comments and other fetal information 124 Case for A AO PARA how 7 1 o ELEME E E m NE oM B o pim C IE I Fie Edit view Scheduling Cases Reports Tools Help Environment DEVI Vitals Totals Comments Anes Arway Monitors Checklist Case Info Events Anes Start y General OB Info j I Cw MS C Labor Analgesia Needed Create C Section Case Uterine Incision Required I WSS iB eres MS 1 E Fetal Gestational Age weeks Closing Comments Out OF Room this area ts for general comments pertaining to the OB section and other relevant fetal information m ds Cete s Specific Birth Information Change User riant Name APGAR APGAR Biihweght Time OfDeivey Tine Of Placenta Deliver 6 oso vida check Case Current User JoshTest Fellow Data Last Refreshed at 13 39 12 13 45 09 Labor Analgesia Needed If this box is checked it will automatically change your case type to that of a Labor and Delivery one The requ
12. Points to remember Be careful when selecting parameters to add to your case as you cannot delete them once they have been added to your list Documenting a Parameter Selected e vTATxTeTa Tr y iT 1 Arta Collect y Un OFF lo i Y Scale Ob ooo 00 0 0060000405 9 9 9 9 0 Bet Past y tals Filter x n Labs i 7 ALL 7X Doo T T NER NER NER NER NER M d 35 4 35 4 35 4 35 4 35 50 Normal Saline cc 500 Ea If you are documenting a specialty parameter you must first add the desired parameter using the steps listed above After all desired parameters have been added you may document in the lower grid by first clicking the tab corresponding to the category you wish to document Vital Resp Anes Gas Hem Labs or All Click in the turquoise box corresponding to the time frame in which you would like to document A box will popup for the parameter you have chosen Either type the correct documentation in the space provided use the drop down arrow to select the correct value The example below is the ECG documentation parameter 74 Del Time Value O 02 05 2008 0845 gt ECG e o add additional documentation in the same cell click on the cell and then click the Add Param button Copying to the next cell If you are documenting values which are the same you may use the copy feature to copy the information from the cell to the
13. Preop Open Case Open Read Only Preview ACH Attending Motes Li vuH3 THR HMB EHDARTERECTUHMY PATCH GAA x gt tr tr dr dt dr dt te a Search by Site Hoam Change User i Search By Date Search by Patient s M ame C3 Today s Cases 3 Yesterday s Cases Date Range from 027 0172007 ta 02 01 2007 My Cases My Incomplete Cases Al My Rooms Current User 999 o Bata Last Refreshed at 15 18 Search Clear My Profile Sa f Ao Case Status Filter Assign Rooms JN El ay V z Exit GasChart 15 18 39 155
14. iferative Informatics amp Computing ool of Medicine Gas Chart User Manual Version 4 0 1 0 VUNETD a caia 4 EPASSWORD seiniin n e a A A A O ra A e aiia 4 RAGE Dicc 4 RACE PASSWORD sivtaicasehtaneacceteacawenscunacatacunetcs a a a a a aa a a e a a 4 LOGGING IN TO GASCHAR TD ivcsiiscasciaccsacivasacececatecenesensvanscucestccesccasasisevadeaseceteccwesesnvancsusnatedinesadscsewsaians 5 INITIAL CASE LIST SCREEN iia 6 PAST DUE GASES rats 6 BUTTONS ON THE RIGHT PANEL caia aaa 7 FEATURES IN THE MENU BAR coa 9 FEE a a desu 9 EDIT Meteo m 9 MEE ep 9 SCHEDULING oc 9 SCHEDULE A CASE ida 9 EDIT TIMES AND ROOMS oscar a 17 CANCEL CASE cia eli aca 18 UNDO CANCEL CASE roiie a a nctians 20 CASE NFO mne 21 Using a Template aan e a a a qua vu oz ea a a Sas UE GRE UE 21 Create 3 New Template iii 22 Copy Someone Else s Template 32 Edit An EXiSting Template coi acia 35 Delete An Exis ng Template siisii a a aRar EE aS Erraina 36 REPORTS PANE Reports ara e a a EU FVN ITE C TCR 36 poo O m 36 VPIMS WEB indias 39 ROTATION EVALUATIONS nia 39 HELP CADOUE ooiseccuetiecctcesicccccncrnsuvecsudinwsdesdinvanevtacscncucadsancuecveaawoucussenescsguausuaueacsecuncedsencmeanmaavene 40 My PROFILE CAPTURING OR CHANGING YOUR SIGNATURE 5 55 555a uuasuuuRRARRRRRR
15. ther o 1 Todd at 9 4 2007 9 03 00 AM Todd Christie m If you make changes to the orders but do not print the updated set you will be prompted 150 Drug Allergies COMING SOON Respiration v Place pt on 40 face tent for 30 mins then if 02 saturations are maintained room air at preoperative level discontinue 02 Place pt on ventilator and obtain ABG s in 30 minutes Rate Peep E TW E Oe amp Pressure Support dm PACU Meds Indication Med Name a A a Bm e S A LA mo Nas Y ma putts Max Units Max Period Interval Haute Dosage Dose a I es feas ve was Dass ones osm vs Mima w O atu mataste it hoe Wd v 3rint Modified Orders Form data has been changed Do you want to print Ehe new orders IF you choose no the orders will show that they were modified by vou but not printed Physician will assess pt prior to discharge C Discontinue A Line in PACU Other FACU Comments If you select No the screen will reflect that the orders have been modified but not reprinted Users Todd Christie we Christie Orders Print Order ka putts Other we 3 kg Needed to calculate weight based dosage E Other Glucose Chest X Ray SMAG Accu Check Orders last modified by Christie Cd Todd but have not been printed ld Christie Ww
16. Special Techniques Induced Hypothermia Circ Arrest Induced Hypotension CP Bypass Field Avoidance ECMO Eye Care Lubricated Scleral Shields Taped Wet Gauze Sewn C Goggles os Cd Thermal Care Routine body warming Convective air warmer Elevated room temperature Passive circuit humidifier Active heated humidifier All pressure points padded C NG Tube OG Tube Standard GA Document desired information in the Anes tab for your template For more information on the Anes tab refer to that section in this document 28 Airway Drugs Fluids moon nes Away Supplemental oxygen only Airway Oral Nasal Bite Guard Mask only LMA AmivedIntubated Arrived Trached C Oral C Nasal LC Trach Direct Laryng Lighted Stylet Fiberoptic In Line Stabilization Blind Bullard Awake Attempts Q1Q0203040A4 Jet Vent L omment rar Monitors Case Info Checklist Mask DL Easy O Easy Moderate Moderate Difficult Difficult Impossible Impossible L N A View Grade Atraumatic Traumatic O10203 04 O 4 Successful Blade Miler 50 01 MACH Oa O1 WHE 15 Ww FSCS ETT Tube Type Size Taped cm Standard C Stylet Lek mmHg Laser Anode Uncufted Preformed RAE C Dbl Lumen Size EM Ta
17. anes rsh NN osos reren G Camera Log H Change User Print Reports send to StarChart Exit Case You will be asked to verify your desire to delete the comment Delete Comment Are you sure vou want bo delete this comment From the case 92 CE MEE ES Lem e EN uem e Le E oes e orare Ls Cw e 1 Dire nere D Camera Log Change User Preop Breaks Attending Motes Emergence Postop WizOrder Billing Comment for internal communication with the Billing Staff Current User JashTest Fellow Data Last Refreshed at 13 22 93 Quick Comments Add A New Quick Comment To add a quick comment a comment you can use for multiple cases click the a Icon When the comment box popup appears click in the white box Then click Create Quick Comment m HI o o ss y ls pr a Edit Quick Comments Quick Comment Name My first Quick Comment Quick Comment Text A new window will open Name your comment then type the comment in the space provided When you have completed the comment click OK Edit Quick Comments Quick Comment Name My first Quick Comment Quick Comment Text This ig my quick comment The comment you added will now appear in the list of quick comments available for you to use 94 My First Quick Comment 95 Use a Quick Comment To use a quick comment that you have create
18. mg albuterol 0 5 0 5 mL in 2 5 mL HS dose albuterol inhaler putts ampicillin sulbactam am aprotinin units aprotinin 10000 KIU mL ml Temnlate Fliide In Tamolats To add a medication to your template list find the desired medication and click Add Drugs Fluids LowerGrid Anes Airway Mmonitors Checklist Case Info Template Drugs Al es Add Freop Med Name Route vw v I v hu d b 4 a qu fentanyl mcg glycopurralate mg ENTE midazolam mg ondansetron mg bo A cec Designate if medication is a Preop Med 25 Template Drips To add a template drip select the appropriate drip medication from the drop down list To delete click the red X se Info Template Drips Del Drip Mame o phenylephrine meg lg min phenylephrine mcg Ea min phenylephrine mcg min phenylephrine 120mcg ml ml hr pipecuranium mar potassium chloride mE qh procainamide mg min propofol Imcg kg min k emplate Fluids Out Template Fluids In Out To add a template fluid input or output select the appropriate fluid from the drop down list To delete click the red X Fluids In Fluid Mame 452 NS with ECL 20 meq ml Dextrose 5 in Water ml Fresh Frozen Plasma ml Fresh Frozen Plasma units GU Irrigation IM mnl ids Lactated Fingers ral LR B Dextrose ml Template Fluids Out Del
19. 4 e ra 100 xj o 1 T Add Marker Jvkonitored ct 8 min Get Past 100 3 Ar esp Anes X M a B Xx x lem Labs L 1 419 99 Cancel a x A box will pop up where comments can be entered NOTE The first time you enter a marker for that time frame the Current Text box will have the word Empty in it Event Marker for 11 05 Current Text Available Quick Comments EMPTY Insert Comment Edit Quick Comment Insert Current Time Create Quick Comment To add text to your marker you may either type in the Current Text box or create a quick comment a comment you can use for multiple cases To create a quick comment for VPIMS Markers click Create Quick Comment 68 Edit Quick Comments Quick Comment Mame VPIMS Marker Test Comment Quick Comment Text A new window will open Name your comment then type the comment in the space provided When you have completed the comment click OK Edit Quick Comments Quick Comment Name WPIM5 Marker Test Comment Quick Comment Text This is the text of my VPIMS Marker test comment use this field to designate any significant times during the case The comment you added will now appear in the list of quick comments available for you to use gue 2mments VPIMS Marker Test Comment 69 Use a Quick Comment To use a quick comment that you have created double click the quick comment you want t
20. 9 My Profile e This button may be used to change or view your personal settings e See the User Manager section of this document for more information 10 Assign Rooms e This button is used to assign clinicians to a specific room for a day 11 Exit Gaschart e This button is used to exit the application Features in the Menu Bar see picture below 3 VPIMS GasGhart Selection Screen File Edit View Scheduling Case Info Template Reports Tools Help Environment PreTest M Date Time Patient Procedures A 03 14 2008 08 00 12 00 Ls cw EXPLORATORY LAPAROTOMY EXPLORA 03 14 2008 12 30 14 30 ede e LAPAROSCOPY SURGICAL CHOLECYSTE Hefresh Screen 03 14 2008 08 00 10 00 dece c EXCISIDNAL PREP CREATIDN RECIPIENT Past Due ACRs 03 14 2008 08 30 32 30 Lese wii LAMINECTOMY W O FACETECTOMY FOR 03 14 2008 13 00 14 00 loses o CREATION SHUNT VENTRICULO PERITC 03 14 2008 08 00 11 00 Ie see ARTHROPLASTY ACETABULAR amp PROIN Open Case 03 14 2008 13 00 16 00 ib ee ARTHROPLASTY ACETABULAR amp PROIN Open Read Only 03 14 2008 O8 00 10 30 eec e SELECTIVE CATHETERIZATION ARTERIA 03 14 2008 11 00 14 00 tese te SELECTIVE CATHETERIZATION ARTERIA 03 14 2008 08 00 12 00 Le twee DIRECT PATCH CLOSURE SINUS VEMOS 03 14 2008 O8 00 09 00 Le 9 DEBRIDEMENT OPEN Fz DISLOCATION 034 2008 14 00 15 30 ee oo OPEN TREATMENT OF DISTAL RADIAL IN se gt Preop Reporte Attending Mates Change User r te t te
21. APGAH APGAR Birth eight or Temp Name 1 min TN Ibis Time Of Placental Time OF Delivery M TetBaya O S ood O O y D Infant Mame APGAH APGAR Birth weight z or Temp M arme 1 min Amino Ibis Meta Time Of Placental Time OF Delivery DAREK Time OF Placental Delivery De j Infant Name APGAR APG R en Ten Belen or Temp Mame SS 5 min 128 Values of 3 or less will alert the user with the following prompt Resuscitation Alert APGAR values of 3 ar less require immediate resuscitation Follow the same steps outlined above to document the 5 minute Apgar score NOTE Apgar score is not a mandatory field but is available for documentation To add the birth weight of the infant click on Birth Weight to add birth weight Birth weight is in lbs Infant Name APGAR APGAR Birth Weight ENTE Time Of Placental E or Temp Mama min 5 min Ib s uda Delve au est Baby A Enter the Infant s birth weight by typing the correct number in the box Birth weight is a mandatory field and is required to close the case Invalid Weight Entry E Please Enter a Valid Weight Cin lbs Click on Time of Delivery to enter the current time and date in the box You may also the type the date and time in the box m Infant Mame APGAR APGAR Birth weight Time Df Placental E d prTempMame Temp Name 1 min mn mini Ib Delivery Click on Time of Placental Delivery
22. August September October Movember December Sun Mon Tue Wed Thu Fr Sat ef 28 29 30 31 1 e 3 4 5 6 7 8 8 10 11 12 13 14 15 16 17 EE 19 20 21 22 23 24 25 26 27 28 29 30 1 8 3 4 5 B 7 Todav 5 18 2007 Enter the Anes Start time to begin charting vitals NOTE The Vitals grid will not enable for editing until this time is entered Click the Anes Start button to enter the current date and time If you do not want to enter the current time you may click in the box marked Anes Start once then click the drop down arrow that appears inside the box The arrow will open a calendar which can then be used to change the date Use the right left arrows to change months Tip to quickly change the month click on the month text displayed at the top of the calendar Use the dropdown box to select To change the hour or minutes of the time click either the hour and use the up down arrows to change To change the minute follow the same steps You cannot enter future times 53 Future Times Not Allowed Future times cannot be entered Time will not be updated OK 2 gt Case for Seg Mv if eese 5 eee mae YA HOPE me M odd Bossi frm PEE 2 File Edit 3 edil Case Info amplate Help Environment DEYDI 03 00 09 15 19 50 Ces El Clear Line Monitored Out OF Room m Anticip Out 08 30 n seine reten f omme Ele ea Check Case EJ i Reports 10 Ready for Attending 11 12 tC _ l
23. Comment for intemal communication with the Biling Staff Current User JoshTest Fellow Data Last Refreshed at 13 22 E 90 Edit Comments You can only edit comments that you have written To edit a comment click on comment you wish to edit Edit the comment ETCTUBENG Cem m anes Ready e ra e ME es E e nas EE e Breaks Check Case Billing Comment for internal communication with the Billing Staff Preview ALH Send to StarChart The comment will appear edited in the comments window You can also add quick comments in the comments box If there is a text field where notes can be entered you will see a d icon If you click on this icon you will be directed to the quick comments page If you have saved quick comments you can use those to fill in the text box Or you can just type in the text box without clicking the d Icon VPIMS Quick Comments Current Text Available Quick Comments Insert Comment Edit Quick Comment Insert Current Time Create Quick Comment 91 Delete Comments You can only delete comments that you have written To delete a comment click the red X by the comment you wish to delete Ti ae VM Case for hiss Billing Comment for internal communication with the Billing Staff gf Current User JoshTest Fellow Data Last Refreshed at 13 22 e Jr x IE vll BI NM nvironmert om Jl E 5 E dressing On ooo ls
24. Fluid Mame Urine Output rl w Estimated Blood Loss rml Estimated Blood Loss ml GU Irrigation OUT ml llleostomy Output rl MG ml OR EBL Total rol OR UOP Total rl Ostomy Output m Designate if Urine Output is not measured for the template and if there is Minimal EBL Lower Grid To filter parameters by type you may click the drop down arrow and select a parameter category 26 Drugs Fluids LowerGrid A Lower Grid Parameters To add a template parameter select the appropriate parameter from the drop down list To delete click the red X Drugs Fluids LowerGrid Anes mm Monitors Checklist Case Info Lower Grid Parameters 27 Anes Drugs Fluids mM Anes Ajay ES Checklist Case TS Anesthetic General Induction Smooth C Difficult Change from local regional Adequate preosvgenation i L Inhalation IM Rapid Seq Dmm 00 Given for Postop Pain Relief Under Anesthesia Spinal Interscalene C Ankle Block Epidural Supraclavicular Single Bolus C Caudal C Iv Regional C Multiple Bolus Asian Block Cervical Plexus Continuous os o C MAC Positioning Supine Tburg LUD Prone R Thug Lithotomy Sitting L Lat Decub Beachchair RiaDemb O Lett Arm Tucked mbBoaid Suspended Right Arm Tucked amp mBoard Suspended
25. NRIBSGEHEN Anes Start and Anes Finish need to be entered by the anesthesia provider The other times will come over from Patient Tracker the documentation tool that the Intraop nurses use if it is used Note When the Anes Ready time is entered the user will get a pop up reminder about antibiotic administration Choose the correct option Abx Alert Reposnse No ABX are recorded as given Please consider administration of Abx Alert Reposnse prophylactic ABX prior to incision if appropriate No ABX are recorded as given Please consider administration of prophylactic ABX prior to incision if appropriate EUM Aby not Indicated fou must enter a reason for not administrating an 4bx to continue Indicates that you will be giving the patient a pre incision Abs No further C Aby not Indicated waming will be given Reason Cultures to be performed No abx necessary for case Other Patient on abx regimen Save 54 Tabs Vitals Totals Comments Q Anes Airway Monitors Checklist Case Info Y Events J Delays OB SCIP EMR 9 Emergence File Edit View Scheduling Cases empale Reports Tools Help Vitals Totals Comments Anes Aingay Monitors Checklist Q Case Info Y Everts O Delays OB ny cefazolin Carm fentanyl meg midazolam mc Selected w v Arx o L T Auto Collect On Off Y Scale
26. Pain Relief A Under Anesthesia Interscalene Ankle Block Epidural Supraclavicular Single Bolus Caudal I Regional Multiple Bolus Axillary Block Cervical Plexus Continuous MAC O Positioning Supine Tburg Prone R Tburg Sitting L Lat Decub A Lat Decub Spinal LUD Lithotorny Beachchair Ig Tucked Arm Board Tucked Arm Board Left Arm Right Arm Suspended Suspended ep Special Techniques Induced Hypothermia Circ Arrest Induced Hypotension CP Bypass Field Avoidance ECMO Eve Care Lubricated Scleral Shields T aped Wet Gauze Sewn Goggles os CC Thermal Care Routine body warming Convective air warmer Elevated room temperature Passive circuit humidifier Active heated humidifier All pressure points padded NG Tube OG Tube Standard G If there is a text field where notes can be entered you will see a d icon If you click on this icon you will be directed to the quick comments page If you have saved quick comments you can use those to fill in the text box Or you can just type in the text box without clicking the d ICOn VPIMS Quick Comments Current Text Available Quick Comments Insert Comment E dit Quick Comment Insert Current Time Create Quick Comment ums JC XX 99 Airw
27. em i Comment To save and exit a TEE click Save and Close TEE To cancel changes and exit the form click Cancel and Exit To delete a TEE click the drop down arrow by Select TEE to edit and highlight the desired TEE Click Delete Selected TEE TEE Data Entry Pre Post ByPass Select TEE to edit Add New TEE Delete Selected TEE Lateral Inferior Anterior Anteroseptal Posterior Support Pacemaker Mutiple Assessment Normal Ascending Normal Diam cm i Grade Plg Transverse Diam cm 20 Grade Flg i Descending Diam cm p Grade Plg e hd Save and Close TEE Cancel and Exit 144 Postop Orders To enter Postop orders click on this tab Case for Postop Ord C mf File Edt View Scheduling Cases Reports Tools Help l Environment DEVO1 Respiration Drug Allergies Place pt on 40 face tent for 30 mins then if 02 saturations are maintained room air at preoperative level discontinue 02 COMING SOCHI Place pt on ventilator and obtain ABG s in 30 minutes Rate Peep TY Oe Pressure Support PACU Meds Dosage Route Interval Period M as Max Units Indication v FALLI Discharge HR Discharge Weight kg Needed to calculate weight based dosage C Discharge from PACU if pt meets the following criteria PACU Labs Other 1 Vital signe are within baseline range C ABG C Glucose C Chest X Ray 2 Neurologic function has returned to preopera
28. est ww select a Template Josh Resident Test Template Enter the name that pau would like to save the template as in pour list Limit pour Template Mame to 50 characters or less Mew Template Name My copy of Josh Resident s template r It will then open the template for you to make personalized changes Click Exit Case when you are done making changes The template will be saved with your changes and appear under your name in the list of templates the next time you open a case 34 Verify and Sign In to Selected Case Noel Tulpan performing Creation Shunt Ventriculo Peritoneal Pleural Other Terminus Cancel ETARE MS Bt Please verify the patient information above Click OK to open this case and signin otherwise click Cancel to return to the patient selection menu Sign In Date Time 09 25 2007 w 1233 Relief Now You are currently caring for 21 patients Please verify that you can care for another No Template Selected lt lt Template Options k Template Owner Todd Christie w Emergency Vascular Trauma Cart Repair of amp aa My copy of Josh Resident s template My first template Hadius Llna fracture Select a Template from your own collection or someone else s Press Cancel Do Not Select Template If You decide not to apply any template to this case as you open it Cancel Do Not Select Template Edit An Existing Template VPIMS GasChart Selection Scre
29. fr te i te te fr r k hy Profile Assign Rooms Dd Oo i Search By Date Search by SiteA oom Search by Patient s Mame 2 Today s Cases CO Yesterday s Cases Case Status Filter 3 Date Range from 03 14 2008 E amp tol 13 14 2008 Search m My Cases My Incomplete Cases Clear HIE ea m ae Exit GasChart 7 Current User Christie Todd Data Last Refreshed at 10 08 O 10 08 47 FILE Selecting File along the top of the applications allows users to Change User or Exit Gaschart EDIT Allows users to perform Cut Copy and Paste functions VIEW Classic View Selecting this option displays the Patient Select Screen SCHEDULING This heading allows users to manually schedule a case edit times and rooms or cancel uncancel a case SCHEDULE A CASE To schedule a case highlight SCHEDULE CASE Case Info Template Reports Schedule Case Edit Times and Room Patient Cancel Case DO C memini F Undo Cancel Case DU AMO 04 11 2008 16 30 18 00 FIM 03 04 11 2008 08 00 10 20 Case Scheduling Wizard Scheduling Wizard Select the type of case you wizh to schedule Select Emergency Add On Case for all cases where there i a medical need to expedite the case into the OA For all other OR cases select Elective Case To document holding room andor recovery room care for patients not seen in UA select Mon 0A Case surgical or non surgical procedures per
30. immediate left of the one in which you are documenting Copying data from the cell immediately to the left e Right click in the cell you would like to copy the information into to copy this information to the next cell Copying data from a cell that has multiple values documented during that time period e f you want to copy a value from a cell with multiple values documented right clicking will copy the last value most current documented 75 05 50 18 45 03 00 09 15 03 30 09 45 Edit Temp C Del Time o 02 08 2008 09 45 CX La 02 08 2008 09 50 if there are multiple values documented in the cell you want to copy Temp C the last value most current will be e copied Copying data into a cell that already has documentation in it e Ifa cell has documentation in it already right clicking will pop up the edit box Edit Temp C 15 09 00 Del Time o o E tox 0815 _ M au d w has documentation E A in it will bring up the edit box H ul a mH Temp C EE oe A O AU AL BL L 1 1 L L d G Copying data from a blank cell of the first cell in the grid e You cannot copy information from a blank cell or the first cell in the grid 76 Points to remember v Some of the lower grid parameter such as respiratory rate and ECG values will be auto collected and plotted for you v Grid values that appear in blue mean that multipl
31. madkal record Per od ita iiam ben Surpesa c Shae David Time Tracking Amer Start 18 14 Amer Fink 3100 Pi lm foam j is fiar Cf Am inso inci Frec iuri ILE E Prac Fink pac Total Ano Vine hix d mn Total CHE Vie ho Monn Preoperative System Check Ernsrt al and Supplemental Checks Performed Make a selection VPIMS Previous Anesthetic Care Record v 135 Emergence Business Rule You cannot document Emergence information until the Out of Room time is entered When you have entered an Out of Room time you may click on the Emergence tab along the top of the screen Case for eeu is SFA om W og RIA ub mum rear frmCase aak Fie Edit wiew Scheduling Cases Reports Tools Help Environment DEYO1 Mortars cres TE Emergence 10 09 E C Smooth Reversed Suctioned Extubated AnesReady Transport PACU Post Op Note PACU Vital Signs Incision f To Airway MS O Pacu O icu Mask NC C Intubated pie dx Desing n Holding Room Tpiece Ambu bag er ae il Out Of Room 10 09 Ventilator Status zu LEJE Bette nes Finis 10 09 E L Awake L Unconscious Adequate Respiration HR BPM 1 Stable Unstable Al Send Page Page Refresh Irway Mask NC Intubated TE NADAN T piece Ambu bag Other E zit _ Ventilator Moving Extremities Disposition Postop A t gi Transport Monitors _ Postop Report given
32. the initials or name of the person who sent for the patient To select a location where the patient will be brought click the drop down arrow by LOCATION and select a location from the list RED PHONE HOLDING PACU OTHER 17 DOCUMENTI NG AN ADD ON CASE You may also indicate if the case is an add on by clicking the box marked IS ADD ON CASE The priority of the add on can also be designated numerically To do this enter the order in which the case was boarded if it is the first add on of the day you would type the number 1 in the box marked ADD ON PRIORITY DESI GNATI NG CASE TYPE 1f To designate a case as an OR Case default Non OR case or Recovery Only click the drop down arrow to select from the list Designating a case as Non OR or Recovery Only limit the documentation requirements If the patient is bypassing both Preop and Intraop phases Recovery Only should be selected Checking this box disables the requirements in Preop and Intraop tabs and allows the user to skip directly to the Postop tab and PACU documentation On the main screen the case will be flagged as such SECURITY RISK The information imports from the ORMIS scheduling system It reflects any security risk that the patient may pose to himself or others It can also be edited here if necessary ISOLATION PRECAUTIONS The information imports from the ORMIS scheduling system It reflects any isolation precautions that the patient has It can also be edi
33. to enter the time the placenta was delivered p ee Infant Mame APGAH APGAR Birth eight Time Of Del ime LIT Placenta lor Temp Mame Temp Mame 1 min amn min Ibis ME ic Del Once all data has been entered the entry will resemble the following Del Infant Mame APGAR APGAR Birth weight Fo ETP Time Of Placental or Temp Mame 1 min A min Ibs us ui Delivery o Test Baby 4 4 8 5 607 12 01 EDO 12 03 NOTE Time Of Delivery and Time of Placental Delivery are all required fields You cannot move to the next record until you complete these items In the event of multiple births twins triplets etc additional entries can be added by following the same steps as outlined above for each additional delivery To delete an entry just click on the red o next to the entry Clicking on the red o delete entry will bring up a confirmation prompt Delete Row Are vau sure vau want bo delete Infant Test Baby A From Ehe case Points to remember v Checking Labor Analgesia Needed changes the requirements for Case Completion v Remember that you must still fill in an Attending Note for cases that turn into C sections though it is not immediately required in order to create the C section case v Consider using the Uterine Incision required fields only in the case of C section Create C Section Case The Create C Section Case button schedules a new case for the cu
34. 00 08 30 13 00 i 12 00 14 00 0 Patient 13 00 17 00 renr 07 30 09 00 12 30 13 30 ur Procedures DONOR NEPHRECTOMY INCLUDING COLD PRES REMOVAL UNDER ANESTHESIA EXT FIXATION S LAPAROSCOPY SURGICAL CHOLECYSTECTOMY REMOVAL UNDER ANESTHESIA EXT FIXATION S ACELLULAR DERMAL REPLACEMENT LEFT LOWE AMPUTATION ARM THROUGH HUMERUS RE 4M Refresh Screen Past Due 4CRs Preop Open Case Open Read Only Reports Attending Notes Change User My Profile HET VUHSAMo VLIH3 RM 04 LLL VUH3 BM 05 WUH3 RM 06 C VUH3 RM 08 s 7 VUH3 RM 09 Ready for Complete All None My Rooms All None ee e Current User Christie Todd Data Last Refreshed at 14 20 a 02 06 2007 Y 02 06 2007 Y Unlocked Status Filters The status filters limit the cases in the display window to only the cases that are of the type of status selected By default all of the filters are selected so you see all cases regardless of status e To unselect a status click on the status and the highlighting around the button will disappear e To select an unselected status click on the status and highlighting will appear around the button d Hot In Use In Use he Hat Started Jf Unlocked pes D 7 Completes Locked Ready for Attending 45 Chart in a Case Once you highlight a case and click Open Case it will open a box with that patient s information If it is not the
35. 00 500 ml ty Normal Saline Abx Alert Response Urine Output Although Abs has already been recorded as given please consider administration guidelines of prophylactic ABA prior to incision IF appropriate Data shown below as entered bu lo at 08272008 12 30 Preop Wasted Drugs The Preop drug section lists the drugs times administered and dosages that are documented as given preoperatively on the Vitals grid but can also be documented directly in this section To select a drug for documentation click the drop down arrow and select from the list Enter the numeric amount in the box marked Total Enter the time in the space provided Preop Drugs Y All aM magnesium sulfate am magnesium sulfate fam Del Med magnesium sulfate mg nemi m meperidine mg o G meperidine PF mg methadone mg Methohexital ma methyiprednisolone mg metoclopramide mg metoprolol rg metronidazole ma midazolam mg minnone meg milrinane mg mivacurium ma 87 The Wasted Drug section allows users to waste drugs le narcotics It lists the drugs documented as wasted along with the total amount wasted To select a drug to waste click the drop down arrow and select from the list Enter the numeric amount in the box marked Totals Wasted Drugs Del Med Name Total J o NN NN ote d morphine mg morphine PF mg E naloxone mcg neostigmine mg nicardipine mg nitroglyc
36. 100 Get Past Vitals Filter AL Dse 45 NS with KCL 20 Albumin 253 ml Current User eee o9 Data Last Refreshed ak 09 58 Incomplete Items 9 If all of the mandatory fields for that tab are NOT completed a red exclamation point will appear on that tab Ex Anes Case Info Events and Delays tabs in above picture 55 Vital Signs Tab Vitale Totals Comments Y Anes Arway Monitors Checklist Y Case Info Y Everts Y Delays OB CIO nm OONA Clear Line Line Cor NI TE Features of the Vitals Tab 1 Medications Record e Allows user to document drug and drip information e Clicking the label on the left of the screen will open a popup for adding medications drips and documenting administration specifics e The functionality of this section will be discussed further later in this document 2 Time Scale e This button is used to adjust the grid to document and view vital signs taken at a one minute five minute or 10 ten minute increment The grid times will adjust accordingly depending on the scale chosen Note 5 five is the default setting for Y scale 3 Vital Sign Legend e These buttons are used to designate which vitals you would like to document on the grid If you are unsure as to their meaning hover over each symbol for a definition 56 4 Monitored Button e This button should be clicked before choosing NOTE This is a tog
37. 4 07 2008 v 1020 Anes Stat Fei No Template Selected 49 Verify and Sign In to Selected Case O gt arm me am EH H MRN ORCase ACN Race Sex Female Weight kg DOB 02 25 1946 62 2 yrs gt c performing Exploratory Laparotomy Exploratory Celiotomy Y A YYo Bx S Sep Proc VUH3 RM 02 04 07 2008 12 00 14 00 C have received a preoperative hand off report including patient identification and status of blood product and medication infusions Please verify the patient information above Enter necessary information and click OK to open this case and sign in otherwise click Cancel to return to the patient selection menu Role v wwe um E No Template Selected Template Options gt gt You will also be asked to enter a time The default time is the current time and date Choose Anes Start if you are entering the case at the Anes Start time To refresh the time to the current time and date click Now Choose Now if there will be someone else also signed into the case with you Choose Relief if you are replacing someone in that OR When you are ready to open the case click OK 50 Buttons on the Right Panel 3 Case for A A Pira LIRE IIMM IL TUAE D Lu BRI u abire LENES ES LEER ET frm AE i a File Edit Case Info Tools Help Environment DEV T1 Vitals Totals Cannas l Y Anes Ainvay Monitors I Checklist C
38. APAROTOMY EXPLORATORY CELIOTOMY WWO BX 5 SEP PROC Di COLOSTOMY PROCTOSIGMOIDOSCOPY RIGID DX SEP PROC CLOSURE ENTEROSTOMY LARGE SMALL INTESTINE E Is Direct Transport Case Level L Case Type OR Case m Cancel Save The current times location will be displayed on the left side of the screen You may edit this information on the right side of the screen by clicking in the START TIME END TIME boxes and entering the new time in an hr min format or by clicking the LOCATION drop down box and selecting a new OR The current times location will be displayed on the left side of the screen You may edit this information on the right side of the screen by clicking in the START TIME END TIME boxes and entering the new time in an hr min format or by clicking the LOCATION drop down box and selecting a new OR DOCUMENTING TRANSPORT SPECIFICS You may also add information regarding add on status and transport specifics To indicate a direct transport click the box by DIRECT TRANSPORT You may enter the time that someone went to pick up the patient To enter the current time and date click the box marked PATIENT SENT FOR TIME Otherwise click on the white box to the right of PATIENT SENT FOR TIME You may input the date by using the arrows and you may input the time by typing it in using an hr min format To enter the name of the person who sent for the patient click inside the white box next to SENT FOR BY WHOM and type
39. CHEDSCL CREATION SHUNT YENTRICULO PERITONESL OPEN TREATMENT RADIAL amp ULNAR SHAFT Fe DEBRIDEMENT SKIN PARTIAL THICKNESS v gt Reporte Attending Motes Search by Patient s Name Change User Seach J Ses Case Status Filter Mu Profile from 02 06 2007 to 02062007 My Cases My Incomplete Cases Al Assign Rooms Exit GazChart O 10 53 59 Current User Christie Todd Data Last Refreshed at 10 49 Create a New Template You can make a new template under your name Click Template then New Choose either Blank Template or Template Based on Selected Case Enter a name for your template In the example below the name of the template is My first template Click OK to proceed 22 VPIMS GasChart Selection Screen Seale File Edit View Scheduling Cases Template Reports Tools Help Environment DET Time Patient Procedures 2 OGY FALLOT WO MESES MB El AL UG FALLOT WO Enter a name for your new template L vVEOLAR STRUCTUE Limit pour name to 50 characters or less LWEOLAR STRUCTUE p Cancel ast Due ACRs New Template LATE ATTACHMENT Preop Open Case Open Read Only 022062007 07 15 08 15 Pama ee LAR YNGOSCOPY DIRECT Wewl TRACHEDSCL 02 06 2007 08 15 09 23 M CREATION SHUNT VENTRICULO PERITOMEAL 02 06 2007 10 15 1217 Pabe som OPEN TREATMENT RADIAL amp ULNAR SHAFT Fe Attending Notes O2 06 200 12 00 13 30 fe rom DEB
40. Data Last Refreshed at 13 39 The current time and date will be displayed Edit the time and date by clicking the drop down arrow by the date General OB Info Labor Analgesia Needed ye Required Fetal Gestational Age Comments Create C Section Case Click to Create new C Section Case E DE 2007 1346 this area is for general comments pertaining to the OB section and other relevant Fetal information use the calendar to change the date Use the right left arrows to change months Tip to quickly change the month click on the month text displayed at the top of the calendar Use the dropdown box to select 126 General OB Info Labor Analgesia Needed Create C Section Case Uterine Incision Required 02 06 2007 13 46 Lc Febretury 2007 Sun Mon Tue Wed Thu Fr 1 2 3 4 5 7 8 8 11 12 T3 14 15 16 18 19 20 21 22 23 24 25 26 7 20 Click to Create new C Section Case Fetal Gestational Age Comments this area i for general commenta 672572007 To change the hour or minutes of the time click either the hour and use the up down arrows to change To change the minute follow the same steps General OB Info C Labor amp nalgesia Needed Create C Section Case Uterine Incision Required 02 06 2007 Fetal Gestational Age weeks Comments Click to Create new C Section Case this area is for general comments pertaining to the OB
41. Diagnoses Procedures Surgeons a Code Description Code LongD escription Del Surgeon Anes Ready i Wed FITAAD BREAST PROSAM MB 19340 IMMEDIATE INSERTION B Q A 3w EMT MS General Case Information m Acct No ESA Lut OF Room m m VUH3RM OE ME Anes Finish e 03 14 2008 i E i 1600 2 Times 13 00 16 00 mE Attending Anesthesiologists Residents ECHM s and SANAs reop Breaks S Scheduled Attending SSS Ss Start Time Stop Time Primary Att per Resident Comments Comments Name StartTime StopT ime Todd Christie 03 14 08 10 29 sra _AddeNewRowierDnconinacusTines PA Perrera C have received a preoperative hand off report including patient identification and status of blood product and medication HI ase Business Rule There must be a Resident CRNA or SRNA assigned to the case or the Solo Attending box must be checked 115 Events Add Event This tab is used to document events which occurred during the case These events are used for internal audit only the information does not appear on the ACR If an event occurred click on the desired category in the Category window then in the Event Category window to drill down and populate the events list Away Monitors Checklist Q Case Info Airway Management C system Medication Events ie call M Category Reasan 116 Airway Monitors Checklist Q Case Info E D
42. Dosage Route Interval Period Max Max Units Indication rected S m v e a O ondencetoning Alt V Nw O ssmemo BO ARA 8 Weight amp kg Needed to calculate weight based dosage adenosine mg PACU Labs Other albuterol 0 5 0 5 mlam 2 5 mL M5 dose albuterol 0 54 0 5 mil in mL HS doze l O ABG Ao P Flag F CEC C SMAG C 12 Lead EKG PCv C Accu Check Ma Orders have been printed Todd Christe vt Doe o YOS FACU Comments Enter a numeric dose then select the appropriate unit measurement by selecting from the drop down box 4 F foley present urine output normal 5 Labs post op are normal or appropriate b Temperature is within normal or preop level C Physician will assess pt prior to discharge C Discontinue A Line in PACU marked UNITS Note If the desired medication is measured in a weight based manner such as mg kg hr the correct patient dosage will automatically be calculated for you using the weight that has been entered for the patient when you enter the dosage amount and the units Follow the same steps for Route Interval Period Max Max Units and Indication if applicable Med Name Dose Dosage Route Interval Period Max Max Units Indication To delete an order click the Del button to the left of the drug order you want to delete Respiration Drug Allergies C Place pt on 40 face tent for 30 mins then if 02 saturations are maintain
43. EKG Pulse Ox Reason A Line CVP Comments id Current User po ow Data Last Refreshed at 09 13 C 10 10 12 Fill in the fields on this page by clicking in the boxes that are appropriate You can also add comments in the bottom white comments box at the bottom of the screen If there is a text field where notes can be entered you will see a rj icon If you click on this icon you will be directed to the quick comments page If you have saved quick comments you can use those to fill in the text box Or you can just type in the text box without clicking the d Icon Business Rule You must document that a Postop Report was given 136 Case Disposition You may use the Case Disposition button to report case cancellation or death Case Disposition Time To Phase 1 2 ar 3 Recovery Organ Donor base Cancelled Preoperatively Patient Expired in OF Reason Case Cancelled in OR To Phase 1 2 or 3 Recovery Case Cancelled in OR To Floor Rounding ICU Home etc Planned Hospital Admit Planned ICU Admit If you select a field that requires a time such as patient death or case cancellation a time field will enable for documenting that time 137 Attending Notes This section is where the Attending anesthesiologist enters their notes Only providers working in the Attending role are permitted to access this page Click on the Attending Notes Button to open the section The s
44. Grade Fla i Comment Comments Save and Close TEE Cancel and Exit To enter other data scroll down in the frame below grid and select values from the dropdown or enter data in the textboxes see screenshots below 142 Epiaortic study Comment ortic Valve Structure Valve ype Annulus mm Function Sclerosis Mane Stenosis Mane Valve area Valve area planimetry cme Mean adnt Peak qdnt cido o MEN EEN eee Abd aortic flow Vena Contracta reversal width em Comment Mitral Valve Structure Normal Type Sizelmm Function Prolapse Flail Leaflet s oo Sclerosis Calcification Stenosis Peak qdnt Mean gdrit o Em co NEN Mitral valve area cme Regurgitation Vena Contracta width em mM Syst pulm vein ERO crm 2 Tricuspid Valve Structure Type Sizelmm Sclerosis Calcification Regurgitation m sec pressure mmhg Hepatic Vein Peak gdnt Est FPA Syst fn Comment Pulmonic Valve Structure Marmal me Type Size mm Function PA catheter Visualized w Chamber Sizes Normal LH cm RH em Intra atrial ASD em ea S hunt 143 Comment Diastolic Function Structure Pulm vein flow Mitral Inflawe Deceleration Time mec Tissue Doppler il Color M Mode Comment Pericardium Structure i Effusion
45. I OPHREN CHR a Bt i E E P EE ee T e ow E grece A General Case Information DressingOn 2 Acct No e M oro las Room YOURS RM 0G i Comments Comments e 03 14 2008 fia 16 00 Times 13 00 16 00 TTE weghtkg E Preop Breaks tending Notes Primary Att per Resident StartT ime Stop T ime Mate qm C Solo c Add a Mew Row for Discontinuous Times Send to Star hart C have received a preoperative hand off report including patient identification and status of blood product and medication HI ase Attending Anesthesiologists Residents CRNAs and SANAs A new window will pop up Click on the fields in the boxes to narrow your search When you find the desired procedure double click it Then it will appear in the list of procedures in the lower right box Procedures Body Systems 17 CPT Codes 2 All Code Description Cardiovascular z Digestive System 61615 RESECT EXCISE LESION BASE POSTERIOR E ar RESEET EXEISE LESION BASE POSTERIOR Endacrne Mervaus Eve Female Genital Sub Systems 5 Extracranial Nerves Peripheral Nerves and Autonomic Parathyroid Thymus Adrenal Glands and Carotid Bad l Skull Meninges and Brain Procedures Selected Spine and Spinal Cord Thyroid Gland Code LongD escription Specifics 16 A 1615 RESECT EXCISE LESIO Approach Procedures Anterior Cranial Fossa Base of Middle Cranial Fossa Base of Posterior Crani
46. ISION CSF SHUNT OBSTR Preop OpenCase l Open Read Only LAR NGOSCOPY DIRECT 440 TRACHEOSCEL CREATION SHUNT VENTRICULO PERITONEAL OPEN TREATMENT RADIAL amp ULNAR SHAFT Fe DEBRIDEMENT SKIN PARTIAL THICKNESS v gt Reports Attending Notes Search by Patient s Name My Profile Case Status Filter Assign Rooms v Exit GasChart Find the user and template you would like to copy and highlight it Copy Template Copy From User or Group Select a Template Select a User whose template you wish to copy then select the template you wish to copy from the list Resident Josh Enter the name that you would like to save the template as in pour list Limit Your Template Mame ta 50 characters ar less Mew Template Mame Josh Resident Test Template 33 Copy Template Co From Select a User whose template you wish to copy pY then select the template you wish to copy from the list User or Group select a Template Josh Resident Test Template Enter the name that pau would like to save the template as in pour list Limit Your Template Mame to 50 characters ar less Mew Template Mame Josh Resident Test Template Then rename the selected template to whatever you would like the name to be Click OK Copy Template Co From Select a User whose template you wish to copy l pY then select the template you wizh to copy from the list Uzer or Group Resident JoshT
47. PACU Discharge HR Discharge Discharge from PACU if pt meets the following criteria 1 Vital signs are within baseline range 2 Neurologic function has returned to preoperative status 3 Usi gen saturation at preop level 4 IF foley present urine output normal 5 Labs post op are normal or appropriate 5 Temperature iz within normal or preap level Qe Physician will assess pt prior to discharge Discontinue A Line in PACU Ew SS PACU Comments PACU Discharge HR Discharge C Discharge from PACU if pt meets the following criteria 1 Vital signs are within baseline range 2 Neurologic function has returned to preoperative status 3 Pain is adequately controlled 4 Pt drinks fluids with minimal nausea 5 Surg dressing cast is dry and intact w o circulation impairment 6 Pt is able to ambulate with assistance C Anesthesiologist will assess pt prior to discharge HR Comments 147 Using Creating Postop Order Sets Case for UT I mite AA AAA thee t ott U tt Cid Se 1 NEN te Postop Ord SAA File Edit View Scheduling Cases Reports Tools Help Environment DEYO1 Respiration Drug Allergies Place pt on 40 face tent for 30 mins then if 02 saturations are maintained room air at preoperative level discontinue 02 COMING SOONI C Place pt on ventilator and obtain ABG s in 30 minutes Rate ia Peep TV ia 02 ia Pressure Support i Other PACU Meds Med Na
48. Quick Comments Current Text Available Quick Comments Insert Comment Edit Quick Comment Insert Current Time Create Quick Comment 101 Monitors Tab Click on the Monitors tab to view and edit the monitor information Vitals Totals Comments Anes Airway Monitors Checklist Q Case info Events Delays OB sc amp ISTISTISEIS std GA Std Reg MAL Std LMA Invasive Monitors Arterial Other Monitors C TEE C ICF C Evoked Potential EJ A Anesthesia Placed O Other Placed 102 This screen allows documentation of any invasive or noninvasive monitors IV access and special equipment If you choose NIBP then you must use the drop down box to enter the location Monitors Checklist Case Info Events Delays Special Equipment Fluid warmer Level 1 Infuser TEG _ Rapid Infusion System Hemacue Cereb Osug Monitor A Balloon Pump Cereb Oxyg Monitor L L AD l m Other Monitors TEE O ICF Evoked Potential d A Anesthesia Placed O Other Placed 103 To enter standard information with 1 click you can click on the Std GA button Std Reg MAC button or the Std LMA button Vials Totals Comments Anes Airway Monitors Checklist Case info Everts Delays OB st Special Equipment Fluid Warmer BIS Level 1 Inf
49. RE A FELLOW If you are a Fellow then you must also choose the role you will be performing in the case You may choose either Attending or Resident Verify and Sign In to Selected Case eo were Me M LL E itg g MRN ORCase ACN Gee Race Sex Female Weight kg DOB 02 25 1946 62 2 yrs co performing Exploratory Laparotomy Exploratory Celiotomy YYA o Bx S Sep Proc VUH3 RM 02 04 07 2008 12 00 14 00 C have received a preoperative hand off report including patient identification and status of blood product and medication infusions Please verify the patient information above Enter necessary information and click DK to open this case and sign in otherwise click Cancel to return to the patient selection menu Attending a F Resident Anes start Relief No Template Selected Template Options gt gt Verify and Sign In to Selected Case o wet D e so MRN ORCase ACN MS Race Sex Female Weight kg DOB 02 25 1946 62 2 yrs c performing Exploratory Laparotomy Exploratory Celiotomy W YWo Bx S Sep Proc VUH3 RM 02 04 07 2008 12 00 14 00 C have received a preoperative hand off report including patient identification and status of blood product and medication infusions Please verify the patient information above Enter necessary information and click OK to open this case and sign in otherwise click Cancel to return to the patient selection menu Role mmm Sign In Date Time 0
50. RERRRSRRSSERERRRSRREERRSSRRREN 40 ASSIGN ROOMS incio a 42 SELECTA AS ca 44 Search By SIEG osica E aAa a A aai 44 SEIECE ROOMS ITI TT C I I MEE 45 Status Elite iia iras 45 CHART TIN A CASE cisonmcascni craneal 46 BUTTONS ON THE RIGHT PANEL lt a 51 TIMES PPPoOo5 o0oPPPePP dawatweseuwascebanueceeactens EEA 53 TABS nic nea 55 VITAL SIGNS TAB aaia eaaa a a a teceuansseceuwarewenbaeseuscuseveussuaeauneucasuewscessteuseweabensere 56 Features of the Vitals TaD innato 56 Documenting Vital Ssusse aa dd 58 ALI t Saa 58 QUICK Gee T H dE 59 AUTO Ge e dee ician 61 Correcting a Vital Sign on the Upper Grid eeeeeeee eere rere eee nenne annee nnn nan 64 Erase a Linie of VIEalS iiie iei eeu oo oa Eva Ens vea saeva Sa Voas suae a Ceaus cu Sau sa a E VaPEU a VES RUE E RED EEN EN CERE EM OSS 65 Chart Past Vitalidad 66 Adding a VPIMS Marker cuac euabiucuaweneue a 67 Editing a VPIMS Marr ssiri A A aaa 72 Deleting a VPIMS Marker ira A uUnVV Ew a UK M UE 72 Lower Grid DocumentatlOnh iiiciivaagasruxRsu sgREaEa ER ERR ERR Ra REF POrEEMRER EE CRER SEHR RaRKVRRAESNREERN ARRA ESEHNR ES 73 Adding Vital Parameters 2 2 2 iei Eee ee eco eux oa os pcena aaa 73 DOCUMENTING a Parameter 2 0 dio a i 74 COPYING to ENE NEXE COM Met 75 DOC BUON A ETT TL ET MIR 77 IU Sci bal 77 Adding A Fluid to the LOWEN GING iii ceci 77 Document Fl ldSs
51. RIDEMENT SKIN PARTIAL THICKNESS v gt Reports E E E E 3 E 5 3 B E gt E amp search By Date Search by Site Hoom Search by Patient s Name Change User 3 Today s Cases 2 Yesterday s Cases 2 Date Range from 02 06 2007 to 02062007 My Cases Exit My Incomplete Cases GasChart Current User Christie Todd Data Last Refreshed at 10 54 d To Mu Profile Case Status Filter Assign Rooms gm ag o TE in y If Blank Template is selected the template forms will appear Only the information you can include in your template will be available to you 23 Vitals Template Template Drugs T l Hale Tools Help Enviro Editing the Clinical Pathway My first template frmCase Template Drips Template Fluids In Template Fluids Out Fluid Mame Fluid Mame C UOP Not Measured C Minimal EBL Drugs Fluids LowerGrid An Template Drugs Antibiotic Emergence Induction Local Anesthetic Maintenance Mise Muscle Relax Narcotic Fharmacy Meds Sed Huwpnatic Surg Administered Surg Hequested Vasoactive Template Fluids In Fran F To filter medications by type you may click the drop down arrow and select a medication category 24 Drugs Fluids LowerGrid Anes Arway Monitors Checklist Case Info Template Drugs acetaminophen mg acetaminophen 300 codeine 30 tab adenosine
52. User gt My Profile Assign Rooms tbi Search by Site Fioam Search by Patient s Mame Seach Clear E E Clear Case Status Filter Va Sm Current User Christie Todd Data Last Refreshed at 10 21 Exit My Cases GasChart My Incomplete Cases CO 10 21 13 e When you are finished entering information click DONE The case will disappear from the Main Screen If you wish to see all cases that have been cancelled you may filter the Main Screen to show ALL cases 19 UNDO CANCEL CASE You may undo the cancellation of a case using 2 methods You may highlight the case and select Undo cancel Case from the top menu bar Date 02 06 2007 02 06 2007 02 06 2007 02 06 2007 Time 07 30 10 00 08 30 13 00 12 00 14 00 07 30 10 30 Fatient Procedures DONOR NEPHRECTOMY INCLUDING COLD PAR REMOVAL UNDER ANESTHESIA EXT FleATiok LAPAROSCOPY SURGICAL CHOLECYSTECTOM RENAL ALLOTRANSPLAN TATION IMPLANTATIC ARTERIOVENOUS ANASTOMOSIS OPEN DIREI SPLIT THICKNESS AUTOGRAFT FALE GENITAL MO MY EXPLORATORY LACEMENT LEFT LO UGH HUMERUS RE ARENAL ABDOOM AUF AURTOBIFEMURSL gt you may highlight the case and click the red cancellation icon 20 File Edit View Scheduling Case Info Template Reports Tools Environment PreTest M Date Time Patient Procedures 03 14 2008 08 00 12 00 Road EXPLORATORY LAPAROTOMY EXPLORA 03 14 2008 12 30 14 30 de
53. al Fossa Craniectomy or Craniatomy CSF Shunt Search for text pum u OtherComments Procedures Search for codes LA Then click on the Done button 109 The procedure chosen will appear in the Procedure box Procedures ode Longllezcrnpliar 61615 RESELT EXLISE LESION Commenta 3 Edit Procedures To delete a procedure double click on the name of the diagnoses you would like to delete in the lower right box Procedures Selected Code LongDescription Business Rule You must document either a procedure or a procedure comment 110 Surgeon Surgeon and attending anesthesiologist name should be entered Click on the arrow next to the empty white box and select the surgeon you would like to enter into the case Up to three 3 surgeons can be selected per case The scheduled surgeon should already be populated for you Vitals Totals Comments Y Anes Airway Monitors Checklist Case Info Y Events d Delays OB su H Anes Start 1036 Diagnoses Procedures Surgeons E Code Description InReom NN ce ES Lese E ELTERN dressing on e Cou Oron os Cerne E Comments Comments A imez 13 00 16 00 sms Log i Change User Attending Anesthesiologists Residents CRNAs and SRNAs Camere Log change Use Preop Breaks Scheduled Attending f Del Name Start Time Stop Time Attending Motes
54. ame steps for selecting that time ll EN When the Past Vitals are available you will see a pop up on your screen that says Auto Vitals To view the Past Vitals click the bar A box will pop up with the vitals listed Each vital sign has a checkbox next to it You can Defer Discard or Accept each set of vitals The count of the vital reading you are on is included in the window with the date and time as is the time and date it was taken Follow the same steps as outlined previously to plot the vitals on the grid Adding a VPIMS Marker The VPIMS marker feature allows the user to bookmark times that are significant and comment on those times if desired To add a VPIMS marker find the desired time that you would like to mark Right click at the top of the grid in that time frame e Lase for LX A E SI i Fille Me tedio Case Info Template Tools Help cefazolin gm fentanyl mcg T9 alycopyrrolate mg BEES lidocaine cmg Auto SEE ng 5 min Get Past 100 20 Vitals tals Filter 110 11 15 67 If you have not previously entered a marker there you will have the options to Add a Marker or Cancel Click Add Marker LITIC I 13u rrolate man 0
55. appear and the selected symbol on that time line will be moved to the new location where you clicked Vitals Totals Comments Anes Arway Monitors Checklist Case Info D Everts Y Delays OB SCIP EMR D En Selected e v AIxTeIaTr Suto Collect Or OFF Y Scale Get Past 100 tals Filter M Puta Resp anes Gas Hem Labs uL Ee 5 64 Erase a Line of Vitals E Selected wi viAlxjo s T i Scale 100 Get Past Atala Filter AL Dee Click on the Clear Line button Then hover over the line of vitals you want to delete until a yellow line highlights that line of vitals JE 10 10 00 10 15 10 30 10 45 14 00 11 15 11 30 E 10 00 10 15 10 30 10 45 11 00 11 15 11 30 SH PIER MER MER hr Then click once to remove the vitals on that line 1 45 lt 1 45 A hi IR h Ic EP ht A 65 Chart Past Vitals To get past vitals that you have not charted click on the Get Past Vitals button Case for File X Edit view Scheduling Cases Reports Tools Help Selected a PUO Collect You will see a prompt at the top of the screen to select the earliest past vitals set that you want to have displayed ND AC ARI Aan 10 nn rui AL 1n rnnn 66 You will see a prompt at the top of the screen to select the latest past vitals set that you want to have displayed Follow the s
56. ase Info 19 Events Delays DB Siac Anes Start il Anes Ready BI alxfol 117 lt Clear Line lanitored Out OF Room i 3 min TUE ES Anticip Out 08 30 TY enero reten f Ses rmt FL Le po Check Case EJ Reporte 10 Ready for Attending 11 12 Current User e o 09 31 16 1 Send Page e This button is used to send a text page to another person 2 Refresh e This button is used to gather information into your case in between automatic system refresh times Ex Gather time information entered by the circulator in Patient Tracker in between system refresh times 3 Camera Log e This button will be active when someone is looking at the room through the Vigilance camera e To find out who is looking into the room click on the button to show that user s name 4 Change User e This button may be used to log off and bring the login screen back up for someone else to log in You should never chart under another user s login Always have the previous person log out and log in yourself 51 5 Preop Anes Stat e This button is used to view the VPEC PATCH Clinic preoperative InRom fs evaluations if applicable anes Ready incision J e mme Mj 6 Breaks DressingOn 5 e This button is used to document any breaks and allows users giving OutOfBoom JE breaks to enter their name and times without loggin
57. ase Scheduling Wizard Scheduling Enter or verify if imported from scheduling system the OF room date times surgeon and procedures to be performed if any below Items shown in red are required for all cases OR and MNor OR alike Location and Times Date start Time 08 00 Primary Svc Stop Time 09 00 Procedures Site Room Case Type OR Case Cancel Again the fields marked in red must be completed Verify that the information on this screen is correct and click FINISH You will get a message saying the case is now scheduled 16 Case Scheduled AJ Your case is now scheduled EDIT TIMES AND ROOMS To change the room number or scheduled time for a patient click on this icon Edit 5cheduled Times or Room Left panel indicates times as ORTGIMALLY scheduled Enter new or edit existing times and or room in the right panel labeled New Times and M Room to reschedule case and or move case to a different roam Original Times and Room New Times and Room 4j 7 2008 Start Time ai Start Time 07 30 End Time i 30 i End Time 11 30 Date Hil y Date Location IM H3 RI Location YOH RM 02 Patient Sent For Time Sent For By hom Location Patient Sent To Security Risk Isolation Precautions None Anesthesia Required Hospital Room E Surgean l C Is Addon Case Procedures IX A AS EXPLORATORY L
58. ay Tab Click on the Airway tab to view and edit airway information witals Totals Comments Anes Airway Monitors Checklist Case Info Q Events Delays DB 08 46 Airway Mask DL INE Supplemental oxygen only Easy Easy d Atraumatic 09 04 2 ree _ Moderate Moderate Traumatic I Mask only way C Oral Difficult E Difficult incision JS C LMA Nasal Impossible Impossible Desa B i MA 29 eni vien Grade O1 O2 O3 O4 O l oso T ss Arved Intubated Amved Trached a L l Successful Blade Du fRom J Intubated in OA bu Anesthesia staff e Mile O0 O1 O2 0304 P AnsFnsh S Oral C Nasal Trach mach O0 O1 O2 O3 O4 inp Ou 1000 2 Direct Laryng C Lighted Stylet C Blind WHE 1 5 In Line Stabilization Awake oe ee Standard Sire Taped Jem LIO DD Do x lt _IAA AA gt C Laser Stylet Leak mmHg Anode Uncufted Preformed RAE Dbl Lumen Size m Taped G em D Check Case 7 Preview AUR Send to StarChart Jet Vent Fill in the information by checking the white box Business Rule Once you click any of the intubation options the mandatory airway confirmation choices will appear in red This confirmation is a required item If the airway is Standard General Endotracheal Anesthesia you can click on the Standard GETA button to fill in the sta
59. azolam 2 mg Wasted Drugs Preop Drugs Show Fluids To view all documented fluids click the Show Fluids button Fluids are pulled from the documented information from the Vitals tab You can also click on a specific fluid to view time amount and whether it is an input or an output 85 Fluids Administered Show Fluids Fluid Totals Aby Admin J UOPNotMeasured Minimal EBL Estimated Blood Lass 100 ml Out Lactated Ringers 1000 rl In Normal Saline LC 500 ml In Time Amount Direction m Damm m Fluid Totals Click on the Fluid Totals button These values are pulled from the Vitals tab Click on a fluid to see the details listed in the Administration Details window Total Fluids Administered SS asl Show Fluids Fluid Totals uo asurec nimal EE Crestalloid amp 5mhn Time Fluid Mame Amount Mrectio Crystalloid 1400 min 9 00 In Crystalloid 800 ml In 9 00 Estimated Blood Loss 100 ml Qut 3 30 Normal Saline 100 ral OF EEL Total EL ml Out 09 30 ORB v Fluids Total 1400 ml In 0 45 Normal Saline ABX Admin Click the Abx Admin button to view or edit your responses to the antibiotic prompts at the start of the case 86 tals Totals Comments Anes Ainvay Monitors Checklist Case Info Events Delays OB SCIP EMR Er Fluids Administered C UOP Not Myssured C Minimal EBL 100 ml Qut l Time Amount Direction 11
60. bar of the application Calculator Selecting this item brings up a calculator for use You may also change the calculator from Standard to Scientific by clicking View then selecting the desired type 36 E Calculator Edit View Help B TT NN RENI 6 EXC JEJE Ee b BONO bs DOOR 6 BRE ABL CALCULATOR Selecting this item allows users to calculate allowable blood loss for a patient To use select the gender weight in kg starting hematocrit and transfusion hematocrit for the patient then click Calculate The allowable blood loss will display in the box ABL Calculator Patient Gender O Male Female Patient Weight B Kg Starting HCT Transfusion HCT Estimated ABL mL INFUSION GUIDE This feature contains recommended starting rates for a collection of drugs given operatively Note the example below is for viewing only the rates listed may not be correct 37 InfusionGuide Recommended Starting Rate Drug Name Adult Pediatric Berylium 1 ma min Not Recommended m Bolus 1mcg kg over 10 min Dexmedetomidine then 0 2 0 7 mcg kg hr 0 3 mca kg hr Dobutamine 3 mcg kg min 3 mcg kg min Dopamine 3 mcg kg min 3 mcg kg min E THER l 1 meg min n 01 BEA Insulin 0 1 units kg min 0 02 units kg hr Isoproterenol 1 meg min 0 05 mcg kg min Lidocaine 1 4 mg min 20 mcg kg min Mikinone BB rN 10 51 mog kg min Nitroglycerine 2 5 mcg min 0 5 mca kg min Nitroprusside 0 5 meg kg min 0 5 mca k
61. below jes VPIMS GasChart Selection Screen File Edit View Scheduling Case Info Date 03 14 2008 03 14 2008 03 14 2008 0314 2008 03 14 2008 03 14 2008 03 14 2008 03 14 2008 03 14 2008 03 14 2008 03 14 2008 0341422008 t r tt tr tt t tr tr r r tt te amp Search Bv Date 2 Today s Cases Yesterday s Cases 3 Date Range from ta My Cases x Template Time 08 00 12 00 12 30 14 30 08 00 10 00 08 30 12 30 13 00 14 00 08 00 11 00 13 00 16 00 08 00 10 30 Reports Tools Patient dO dieu ips fe uu aa a eii pel 11 00 14 00 08 00 12 00 08 00 09 00 14 00 15 30 Search by Site Hoom x E Help Procedures ESPLORATORY LAPAROTOMY EXPLORA LAPAROSCOPY SURGICAL CH LECTSTE EXCISIONAL PREP CREATION RECIPIENT LAMINECTOM WO FACETECTOMY F R CREATION SHUNT YVENTRICULO PERITC ARTHROPLASTY ACETABULAR amp PROIN ARTHROPLASTY ACETABULAR amp PROIN SELECTIVE CATHETERIZATION ARTERIA SELECTIVE CATHETERIZATION AR TERIA DIRECT PATCH CLOSURE SINUS VENOS DEBRIDEMENT OPEN Fe DISLOCATION OPEN TREATMENT OF DISTAL RADIAL IM se gt Search by Patient s Mame Case Status Filter Environment PreTest M Refresh Screen KE Past Due ACR 2 ro 5 ET change User o My Profile 9 ETTT T0 Exit 0 10 08 47 My Incomplete Cases Current User Christie Todd Data Last Refreshed at 10 08 1 Refresh Screen e This butt
62. ced Hypotension CP Bypass Ot O Inhalation C IM C Rapid Seq L Field Avoidance ECMO Drei etae LD EN SEE Lubricated C Scleral Shields Taped Wet Gauze Under Anesthesia O Sewn O Goggles Spinal Interscalene C Ankle Block O Bl ss Epidural Supraclavicular Single Bolus C Caudal C I Regional C Multiple Bolus Thermal Care Asila Block Cervical Plexus Continuous L Routine body warming MAC Convective air warmer E i Elevated room temperature Meme Positioning Active heated humidifier Supine Tburg LUD Prone A Thug _ Lithotomy All pressure points padded Sitting L Lat Decub Beachchair NG Tube OG Tube RiaDenb CE Lett Arm Tucked amp m Board Suspended Standard GA Right Arm Tucked amp m Board Suspended The mandatory fields are in red You can select a box by clicking in the box It will place a checkmark in the box If it is a standard GA then you can just click the Std GA button and the standard choices will be filled out Business Rule You must document an airway type 98 Vitals Comments Totals d Anes Airway Monitors Checklist d Case Info o9 Events id Delays OB Anesthetic General Induction Smooth Difficult Change from local regional Adequate preoxygenation IV C Inhalation IM Rapid Seq Ced P OOS Given for Postop
63. correct or desired case click Cancel to return to the Patient Select screen Note Opening a case will associate you with that case Use care when opening cases so you do not have a late ACR Verify and Sign In to Selected Case gt sh as MEN ORCase Ne ACH A Cancel Race Sex Female Weight kg DOB 02 25 1346 62 2 urs 1 performing Exploratory Laparotomy Exploratory Celiotomy YYY Oo Bx S Sep Proc VUH3 RM 02 040722008 12 00 14 00 have received a preoperative hand off report including patient identification and status of blood product and medication infusions Please verify the patient information above Enter necessary information and click OK to open this case and sign in otherwise click Cancel to return to the patient selection menu Sign In Date Time 04 07 2008 w 1006 Ho Template Selected To open a case with a template click the Template Options button at the bottom right of the popup Anes Start Relief No Template Selectae lt lt Template Options The lower panel of the box will open if you select the Template Option feature 46 Verify and Sign In to Selected Case wee me MEN ORCase Me ACN wu Hace Sex Female Weight kg DOB 02 25 1946 62 2 urs performing Exploratory Laparotomy Exploratory Celiotomy Yio Bx S Sep Proc YUHS AM 02 0470772008 1200 1 4 00 C have received a preoperativ
64. d e Next click On under the Auto Collect heading When you select On a box will appear so you can choose your collection time parameter Enter the desired time collection parameter Note The time collection parameter can only be a whole number no decimals are allowed Auto Collect On of 5 Y Scale Points to remember v Remember that if you exit the case and re enter you must reset your auto vital collection parameters as the feature resets on exit of the case v Whenever you change the parameter the auto collect feature turns itself off If you change the time collection parameter for auto collecting ie from 5 minutes to 1 minute remember to turn the auto collect back on v Information for vitals signs is pulled from the Phillips monitor in your room If the boxes have no vitals check to make sure the Patient is listed as being in the correct room If the patient is not listed in the correct room you might have incorrect or missing vital signs When a set of vitals has been collected a box will pop up with the vitals listed Each vital sign has a checkbox next to it as well as a timestamp for the time it was collected 61 AutoYitals Vitals From 01 23 2008 09 00 Any Existing Data Will Be D verwritten sa lea lho CC Oles ena 0 a e MESE o mma oo CE Ree RR s em L Bid PULSE O leia sv Mi mHg 0 O DP M mHg 0 Ol jd MP B mHg OO O O Bid sa03
65. d click the ws icon Then double click the quick comment you want to use Available Quick Comments Mo first Quick Comment Insert Comment Edit Quick Comment Insert Current Time Create Quick Comment The comment should appear in the text box VPIMS Quick Comments Current Text Available Quick Comments This is my quick comment My first Quick Comment Case Comments Comments This iz my quick comment 96 Edit a Quick Comment To edit a quick comment click the a icon When the comment box popup appears click the name of the comment you wish to edit Then click Edit Quick Comment Available Quick Comments May first Quick Comment Insert Comment E dit Quick Comment Insert Current Time Create Quick Comment A new window will open with the text of the selected comment Make any necessary edits Edit Quick Comments Quick Comment Name My first Quick Comment Quick Comment Text This ts my quick comment and just edited it Then click the OK button and your changes will be saved 97 Anesthetic Tab Click on the top Anesthetic tab to document anesthetic settings Vitals Comments Totals 9 e Jama Monitors Checklist Case Info E Events O Delays OB z Anesthetic Special Techniques General Induction Smooth Difficult Induced Hypothermia Circ Arrest Change from local regional Adequate preoxygenation Indu
66. ding Motes Change User My Profile Ae E oe oe ee oe oe XR ERO search By Date Search by SiteARoom Search by Patient s Name Assign Rooms Today s Cases 3 Yesterday s Cases 3 Date Range E from 08 05 2008 D a t L My Cases My Incomplete Cases Case Status Filter Exit GasChart Current User olii oum rd cmm a Filth Det 09 26 32 EE Your name will be listed with all of your settings In addition to saving or changing your signature you can also change your pager number email address phone number and default site 40 To change your signature click on the Clear Edit Signature button Profile for User TODDCL First Last Cee ee e Fager Paging Service Provider Satelink Office Phone Default Site VUH3 v Other System Usemames sched Software User ame CAT CN E Clear Edit Signature Ml A new box will open Sign on the line with a stylus and a touch screen or with your mouse if there is no touch screen available Make any other edits as necessary My Profile Profile for User TODDCL First Last Name Christie Todd Role Attending E mail ad Pager r TED Paging Service Provider Satellink Y Office Phone Default Site VUH3 i Other System Usernames Sched Software UserName eae muaa Insert your new signature here using the mouse or stylu
67. e hand off report including patient identification and status of blood product and medication Infusions Please verify the patient information above Enter necessary information and click OF to open this case and sign in otherwise click Cancel to return to the patient selection menu Sign In Date Time 04 07 2008 Y 10 06 No Template Selec select a Template from your oum Template Owner iv collection or someone else s T CUD test Press Cancel Do Not Select Template IF pou decide not to apply any template to this case as vou open it Cancel Do Mat Select Template Too choose an existing template for use on the chosen case click the drop down arrow by Template Owner and select from the list You can select your own name or someone else s Select a Template from your owr Template Owner collection or someone else s Press Cancel Do Not Select Template IF you decide not to apply any template to this cage as YOU open it Cancel Do Mat Select Template select a Template from your own Template Owner collection or someone else s Press CancelDo Not Select Template IF You decide not to apply any template to this case as you open i PEDI HEART Cancel Do Not Select Template THORACIC Next select the chosen user s template that you would like to use for your case The highlighted template name will appear in orange next to template Options If you have chosen in error you may reselect fr
68. e vitals were documented in that time frame v To copy from one cell to another you must have documentation in the cell immediately to the left of the cell you want to copy values into Doc Button To see all of the fields in which you have documented click on the Doc button This will display the parameters that you are using from all 8 parameter boxes Vitals Resp Anes Gases Hemo and Labs wtals Filter ALL Bio ECG Temp C TOF Mode RF Tw aH Fluids all 14 00 NR 36 4 T Spont 15 500 74 The blue section at the bottom of the lower grid is for fluids When a case is started there are no fluids listed In order to document fluids you have to add them Adding A Fluid to the Lower Grid e To add a fluid for documentation click the Fluids label on the left of the screen 77 A new box will pop up Click the checkbox next to what you want to add When you are done adding fluids click the OK button Edit Parameters Available Add Fluid A453 NS with KCL 20 meq ml VM iblbumin 25 ral J MA garmin 5 ml E uj Ascites ml E Cell Saver Blood ml E Chest Effusion ml E Chest Tube 1 ml E Chest Tube 2 ml 7 Chest Tube 3 ml Edit Selected Fluids Selected The added fluid will appear on the grid pH O T 45 NS with KCL 2D i Albumin 2535 ml SS ee queri pem 78 Document Fluids
69. ed room air at preoperative level discontinue 02 C Place pt on ventilator and obtain ABG s in 30 minutes Rate y Peep lai Tv 02 Pressure Support 2 4 C Other PACU Meds Med Name Dose Dosage Route Interval Period Max Max Units Indication o morphine ma v d 11 ma w 46 Hours Pain Sc T o ondansetron mg v 4 ma JA i i Nausea va vw Weight kg Needed to calculate weight based dosage Other Glucose C Chest X Ray SMAG C 12 Lead EKG Accu Check 1 Vital signs are within baseline 2 Neurologic function has retu 3 Oxygen saturation at preop le 4 If foley present urine output 5 Labs post op are normal or a No Orders have been printed Are you sure you want to delete this Drug from the Postop Order B Temperature is within normal Dther l C Physician will assess pt prior to discharge Todd Christie 4 C Discontinue 4 Line in PACU C Other PACU Comments Save Order Delete Order 146 Verify the deletion at the prompt PACU Labs Other Click the desired boxes PACU Labs ABG Glucose A CBE SMAG PC Accu Check PACU Discharge HR Discharge Select the desired boxes by clicking them To enter PACU or HR Comments type the desired comments in the box es provided
70. edication you wish to add by highlighting it Add Medication Drug List ma Time Administered Enter the time the medication was given 81 How to enter times Click the Time Administered box Clicking this box will input the current time automatically To enter a different date click the drop down menu icon by the date field Use the right left arrows to change months Tip To quickly change the month click on the month text displayed at the top of the calendar Use the dropdown box to select To change the hour or minutes of time click either the hour or minutes and use the arrows to increment decrement Dose Enter dose in the box provided Route Click the drop down arrow and select the correct route of the drug from the list Given By Displays Anesthesia Comment Click inside the white box and type any pertinent comments WHEN YOU ARE DONE ENTERING THE DRUG click Done If you wish to cancel the entry click Cancel Add Medication Drug List Medication Preparation 2 chloroprocaine 1 ml 2 chloroprocaine 1 cc 2 chloroprocaine 2 ml 2 chloroprocaine 2 cc 2 chloroprocaine 3 ml 2 chloroprocaine 3 cc abciximab mocgkg min abciximab mg acetaminophen mg acetaminophen hydrocodone tab acetaminophen oxycodone Time Administered il Pharmacy Dispenser Dose C Surgeon Requested C Surgeon Administered Given By Verified By Comment Cancel Done The drug will appea
71. elays I SCIP EMR d Emergence Air way Management Y system Medication Events Mic allamac i Chipned ar loose booth Laryngospasm Reintubation unplanned Soft tissue trauma Category Reason Double click on the event you would like to add It will appear in the Selected Events box J Away Monitors Checklist Case Info Events Delays Airway Management CY system Medication Events hie cell ar cmi Chipped or loose tooth Esophageal intubation Laryngospasm Reintubationrunplanned Soft tissue trauma Category Reason Airway Management Chipped or loose tooth 117 Delete Event To delete an event double click it Then click Yes to confirm Arai Monitors Checklist Case Info SP Events Delays Il Airway Management CY system Medication Events hicr all arni Chipped or loose tooth Esophageal intubation Laryvngospasm Reinkubationtunplanned Soft tissue trauma Category Reason Airway Management Chipped or loose tooth Delete Event Are vou sure you wank to delete Airway Management Chipped or loose booth event From Ehe case WARNING Removing this entry will automatically delete your Events comments 118 No Events Occurred If no events occurred then check the white box next to No Events Occurred ray Monitors Checklist Y Case Info Q Events d Delays ll Air wav Management Ce s
72. en AE File Edit View Scheduling Cases Reports Tools Help Environment DEVO1 02 06 2007 Emergency Vascular Trauma Cart Repair of Aaa 02 06 2007 02 06 2007 08 00 09 30 02 06 2007 09 30 11 30 Refresh Screen My copy of Josh Resident s template My First template Past Due ACRs PALATOPLASTY CLEFT PALATE ATTACHMENT Preop REPLACEMENT REVISION CSF SHUNT OBSTR 02 06 2007 08 00 10 30 02 06 2007 11 00 12 00 Open Case 02 06 2007 02 06 2007 02 06 2007 02 06 2007 07 15 08 15 08 15 09 23 10 15 12 17 12 00 13 30 LARYNGOSCOPY DIRECT WWO TRACHEOSCI CREATION SHUNT VENTRICULO PERITONEAL OPEN TREATMENT RADIAL amp ULNAR SHAFT F DEBRIDEMENT SKIN PARTIAL THICKNESS Open Read Only Reports Attending Notes gt Search By Date Change User Today s Cases Yesterday s Cases Date Range from 02 06 2007 v to 02 06 2007 C My Cases C My Incomplete Cases Search by Site Room Search by Patient s Name My Profile Case Status Filter Assign Rooms C VUH3 RM 09 v My Rooms All None Current User Christie Todd Data Last Refreshed at 12 33 Exit GasChart 35 To edit an existing template select Template then Edit then the name of your template that you wish to edit The template will open for editing When you are done making changes click Exit Case Delete An Existing Template VPIMS GasChart Selection Screen Sele File Edit View Sched
73. enn meg nitroglycerin ointment 2 inches nitraglycern transmucosal ma 88 Comments Click on the Comments tab at the top Del QC Name Comments Anticip Out via rage Fein Ss erre Peo E Atending notes gt ines Postop wizOrder Check Case megas esent Sites Ent Care TOUR Billing Comment for internal communication with the Billing Staff d Click in the Comment field Use the keyboard to enter your comments in the yellow space Anticip Out i Noia pase reten Del HC Name Comments 3 E Click here and start typing your comments Change User mA 7 EUN ETUE attending Notes megane Postop Check Case Billing Comment for Internal communication with the Billing Staff Preview ACA cil Send to StarChart Print Reports L So 89 Click off of the comment field The comment you just entered will appear in the comment box Comments appear in the order that they are entered Individual comments are separated for ease in reading Case fol A aem ai tet io tit Bojh E ho a L i Pub xd abies cg Er NEL 0 ID IX Environment DEYO1 4nes Stark n Del GC M E t el GC Name Commen s Anes Ready n e f Fellow Click here and start typing pour comments e incisi n J E eg ME ENG mata e Pomar E E ES oia roses nen Emergence Billing
74. eoperative hand off report including patient identification and status of blood product and medication 112 Residents CRNAs and SRNAs Modification of sign in out times for anesthesia providers is performed here Click the Sign button to enter your name and signature when you are logged into the case It will also document your time in the case To enter time out just click on the white box to the right of where your time in is listed J Case Info Vitals Totals Comments Q Anes Aina Monitars Checklist 9 ed I Delays DB SI 5 Diagnoses Procedures Surgeons Code Description Code LongDescription Del Surgeon General Surgery Ge 69 m General Case Information Acet No APA Room VLIH3 RM DB E E Lem E Lee E E CE EN 16 00 2 Comments Comments ate 03142008 Times 13 00 16 00 Attending Anesthesiologist Residents CANAs and SANA Scheduled Attending fo Del Mame Start Time Stop Time Attending Notes Primary Att per Fiesident o IE NEL M 03 14 08 10 29 NEM Mame Start ime StapTime Note i os Check Case Preview ACA A mmml H TO DET Add a New Row for Discontinuous Times Ready for Attending a infusions To edit times click in the box of the time you would like to edit and change the time To erase you
75. eta Blockade in Patients at Risk for Perioperative Myocardial Infarction NO 466 ESTABLISHED 2005 APPROVED PAGE NO 1 OF 3 REVIEWED REVISED 134 EMR Tab This tab allows the user to review portions of the patient s electronic Medical Record To access this feature click on the EMR tab i Case Info 1 gm You may select portions of the EMR by clicking the drop down arrow at the bottom of the screen You may select from StarPanel VPIMS Preop Report or VPIMS Previous Anesthetic Care Record Note To view Star Panel you must be logged into your workstation as well as GasChart VPIMS Previous Anesthetic Care Record PIMS Preop Report uu Make a selection rent User Christie Todd omments es Arway Monitors ecklist ase Info vents elays c Anes Airway IM Checklist Case Info E Delays OB scip EMR Ple E ACA 315 TF 2 ga Adobe Acrobat Professional File Edit View Document Comments Forms Tools Advanced Window Help Vanderbilt University Medical Center THE AMODER MILT CLIMEC WAHDERPILT HOSPITAL Department of Anesthesiology ANESTHETIC CARE RECORD DOS 9282006 Original 05 28 2006 22 20 Diagnosae es Mood For Dialysis Seen urge n mair in ther madkal reser For add li boreal er hee Procedure s Creation Av Fistula Kaoz Dirsct Sep Proc Ian Autogzenaus Graf jee Surgeon s rexiz inthe
76. ets for future use find the desired provider name and highlight the order you wish to save Click Save Order Save New Order Please enter a name for your new Order Arlbther Provider s order You will be prompted to enter a name for the order set When you are done click OK The new order should now appear on your list of order sets ES Another Provider s order q__ knee replacement Test orders 1 When you have finished entering orders you may click the Print Orders button Select which document you would like to print and select a printer Then click Print 149 Print Reports a Select the reports that vau wish to print enter any necessary parameters and then press the print button Frink Reports Select Report Mame Printer EI n DoctorsOrders 201 Oxford House OH 201 MCE Preop Area MCE Preop Medical Intensive Care Unit YUH MICLU Medical Support Services Materials OP Materials Neonatal Intensive Care Unit YUH MICLI Neuro Intensive Care Unit YUH NCLIT For additional reports please visit the YORS website or click here to launch a copy of Ehe YORS webpage If the orders have never been printed the screen will reflect as such 7 Needed to calculate weight based dosage Other ose Chest X Ray t amp kg Needed to calculate weight based dosage Labs Other BG C Glucose Chest Rap BC SMAG sad Cy C Accu Check Orders last printed by Christie
77. eview ACA Send to StarChart Exit Case You may also exit the case from the Case Check screen if the case is complete l Mo Just Exit the Case Yes Send to Star hart Exiting a Case takes the user back to the Patient Select screen Gaschart can only be closed from the Patient Select screen To exit the application click Exit Gaschart 154 VPIMS GasChart Selection Screen File yO m om Edit View Site i VUH3 i VUH3 Li VUH3 Li vuH3 Li vuH3 Li VUH3 i VUH3 5 VUH3 5 VUH3 Li VUH3 5 VUH3 Scheduling Date 02 01 2007 02 01 2007 02 01 2007 02 01 2007 02 01 2007 02 01 2007 02 01 2007 02 01 2007 02 01 2007 02 01 2007 02 01 2007 0240 2007 ases Template Time 07 30 09 30 12 30 14 30 10 00 13 00 13 30 15 30 07 30 10 00 10 30 12 30 13 00 14 30 03 40 05 10 07 30 11 00 07 30 09 30 08 00 09 00 09 30 12 30 Reports Fatient b nae Tools Procedures CREATION AW FISTULA NOM DIRECT SEP PRC CREATION Av FISTULA NON DIRECT SEP PAL SPLIT THICKNESS SUTOGRAFT TRUMESSEALF EXCISIONAL PREPYCREATION RECIPIENT SITE ARTERIOVENOUS ANASTOMOSIS OPEN BY UF ARTERIOVENOUS ANASTOMOSIS OPEN B r UF ARTERIOVENOUS ANASTOMOSIS OPEN DIREI TRACHEOSTOMY PLANNED SEP PROC COLOSTOMY SEIN LEVEL CECOSTOMY EXLISI EXCISIOMAL PREP CREAT lOrttghwhgergerngwertg INSERTION TUMMELED CENTRALLY INSERTED See Help Refresh Screen f Past Due ACH
78. f narcotics vials should also be recorded here To enter a wasted drug click on the Totals Tab Drugs Administered G hory Fluids Fluid Totals HOP Not Measured Minimal EBL Time Amount Divided vazsopressin 4 units Preop Drugs Wasted Drugs abciximab mg Al v abciximab ma m Del Med Name Total Time o 3 Med Name CA IE To select a drug to waste click the drop down arrow and select from the list Enter the numeric amount in the box marked Totals Wasted Drugs morphine mg morphine PF mg naloxone meg neostigmine mg nicardipine ma nitroglycerin meg nitroglycerin ointment 2 inches nitraglycern transmucozal ma 84 Totals Tab Click on the Totals tab at the top of the screen to document and view the total values Vitals Vitals Totals Comments pcd Away Pona Checklist Case intal Events PEU DB Drugs Administered cefazolin 1 gm Preop Drugs Wasted Drugs Al w Z chloroprocaine 1 ml 2 chloroprocaine 1 rl 2chloroprocaine 1 ml Add add 2 Chloraprocaine 12 rl v Del Med Mame 1 Total Show Drugs By default the Show Drugs button is chosen These are pulled from the documented information from the Vitals tab You can also click on a specific drug to view time and route Drugs Administered v UDP Not Measured v Minimal EBL fe NN glycapyrralate 0 6 mq mid
79. formed outside of the OA C OR Case Emergent OR Case Non OR Case C Recovery Only Case Labor And Delivery Case Is Add on Case Cancel You may then select OR CASE EMERGENT OR CASE NON OR CASE RECOVERY ONLY CASE LABOR AND DELIVERY CASE lz Add on Case Add on Priority There are also fields where you can choose if the case is an add on If you check this box another field will appear to choose a priority for the add on in what order it was boarded Priority is required if ADD On is selected If you select OR CASE NON OR CASE RECOVERY ONLY CASE or LABOR AND DELIVERY CASE a new screen will appear with new choices 10 To import case and patient information from an external scheduling system by scheduled case number click Import Case ou may also click List Cases Mot ret Imported to display a list of cases scheduled for today that have not pet been imported into V FIMS Import Case List Cases Mot yet Imported Schedule Case Manually If you select EMERGENT CASE a new screen will appear to select a case level and enter comments if necessary Indicate the level of medical urgency for the case If there i no medical urgency click Back and select Elective Case _ None Level 1 Most Urgent Medical Need Level 2 Urgent Medical Need C Level 3 Least Urgent Medical Need Level 4 Next Available Regularly Scheduled Time Case Level Comment Clic
80. g in officially EN Eici Dut 08 30 5 7 Attending Notes I send Page 2 e This button is used by the Attending They enter their documentation 3 J camera toa change User 4 into this section 5 Feo 6 8 Postop Orders 8 e This button pulls up a form to document postop orders 9 Check Case Reports MO e This button is used to check for information missing from a case before Reads for dtending tt Exit case f it can be closed It will make sure all mandatory fields are populated and a pop up box will inform the user which mandatory items have not been completed 10 Reports e This button is used to view the available reports for the selected case 11 Ready e This button is used to print out the ACR to PACU 12 Ready for Attending Send to StarChart e This button is used to send the case to the Attending for his her completion and submission to StarPanel or send the case to StarPanel if your role is Attending 13 Exit Case e This button may be used to exit a case It does not finalize a chart nor does it exit GasChart entirely 52 Times MI el tom Je uestes JT Leere e ues O rem TL Ls cons off cere s CTE EA CL A mG oo 06 18 2007 09 35 2 June 2007 Sun Mon Tue wed Thu Fri E eo 3 30 31 1 b 7 8 13 14 15 20 1 22 ef 20 23 SU 4 5 b 7 671872007 0 1 7T ours Pager January February March April May June July
81. g min Norepinephrine 2 sin 0 05 A Phenylephrine 10 meg min 0 5 meg kg min Pitressin 0 1 units min Not Recommended Procainamide Load 1 4 mg min 15 mg kg over 30 60 min DRIP RATE CALCULATOR This feature allows the user to determine the IV pump setting for intravenous infusions To use enter the correct values for patient weight in kg drip concentration ex 1mg 1ml and desired rate ex 1mg kg per 1 hr then click CALCULATE Drip Rate Calculator Patient Weight 3 Kg Drug Concentration 4 Pump Setting 2 mL hr CONVERSION CALCULATOR Use this feature to convert weight height and temperature to metric values 38 Conversion Calculator Enter the value you wish to convert then click Calculate HGS Fahrenheit degrees Celsius pounds kilograms Enter the value you wish to convert in the desired space then click CALCULATE VPIMS WEB Selecting this feature will direct the user to the VPIMSWeb Main page General Use Clinical Sites Other Sites Event Calendar Anesthesiology VORS eBlade Timesheet Calculator ched View ORMIS FIC StatusBoard VEMS Utilities Anes Schedules b OR Summary Reports ROTATION EVALUATIONS Selecting this feature will direct the user to the VPIMSWeb Rotation Evaluation page 39 os T TZ CEBA Ip Star Panel VUMC Home ET Call vac Reports evaluations Misc Links Trainee Rotation Eval
82. gle button so clicking the Monitored button will allow you to choose vitals you want to document on the grid when you Quick Collect a set Once clicked the word Monitored will appear as a heading over the vital sign legend but the button title will change to Selected e f you forget what the monitored button means hover over it for a definition 5 Clear Line e his button is used to clear a line of vitals on the grid e The functionality of this button will be discussed later in this document 6 Auto Collect e These buttons are used to activate and deactivate the automatic vital sign collection and population feature of Gaschart Once On is clicked another textbox will appear to allow you to set a collection frequency 7 Y Scale e These buttons are used to adjust the grid to document and view vital signs in different ranges User can choose to view and document in ranges of 5 point 10 point or 20 point increments Note 5 five is the default setting for Y scale 6 Get Past Vitals e This button is used to bring up available vitals for a time period 9 Vitals Filters e These buttons are used to filter vital signs into categories for easy viewing You may view vitals separately by the following categories Vitals Respiratory Gas Hematological and Labs There are also settings to view all vitals together All as well as only the categories with vitals you have documented Doc 10 Vital
83. gnoses in the lower right box Then click on the Done button Diagnoses Body Systems 20 ICD 9 Codes Certain conditions originating in the perintal period Complications of pregnancy childbirth and the puer Congential anomalies 7 Diseases of the blood and blood forming organs Code Description 34 8 MENTAL DISOR NEC OTH DIS 294 9 MENTAL DISOR NOS OTH DIS Diseases of the digestive system Diseases of the genitourinary system Diseases of the musculoskeletal system and connec Diseases of the nervous system and sense organs Diseases of the respiratory system Sub Systeme 138 Accidental falls Accidental parsoning by drugs medicinal substance Accidental posoning by other solid and liquid substa lt 29501 SIMPL SCHIZOPHREN SUBCHR 295 02 SIMPLE SCHIZOPHREN CHR Ne ee eae e 0 0 0 AAA TEA TOTES EE Accidents caused by fire and flames CREO fedi Ue SCIRE El Accidents caused by submersion suffocation and fi Accidents due to natural and environmental factors Acute respiratory infections Acute rheumatic Fever Air and space transport accidents Lther Comments Diagnosis Search for codes po Now By CPT The diagnosis chosen will appear in the Diagnoses box 107 Comments Arway Monitors Checklist Case Info O Events Anes Statt_ 10 35 5 mRem e LAwsRen TS mim e Oe E Dressing J OuOfRom S anes Finish Je
84. ical record number for the patient you wish to schedule and click Next IF the correct patient is nat shown click Back and verif that the correct medical record number has been entered The final screen contains case information Some of the information can be edited Case Type Surgeon Primary Service Procedures and Anesthesia required Verify or edit the information as necessary and click Finish Case Scheduled 1 Your case is now scheduled If the case has imported successfully you will get a message stating that the case has been scheduled If the case does not exist in the VPIMS system it cannot be imported Refer to your department s policy for correcting or adding medical record information Scheduling Conflict This patient has not been previously added to the scheduling system with this Medical Record Number Please check the scheduling system again SCHEDULE OR CASE This function is used to manually enter a case in VPIMS It is used in downtime procedures when there is no interface communication between VPIMS and an outside scheduling system 14 Elective Case Enter the patient s medical record number below and click Next IF the patient has been scheduled in Scheduling System enter the scheduled case number otherwise a new case number wil be created Scheduled Case Number mee Medical Record Number You will be asked to enter the medical record number of the patient who
85. ignature and start time of the person signed into the case will appear in the next available attending box Click on the white End Time box to enter your end time Attending Notes for 4e toam arm d ae o eee net Pe 3203 A at File Edit Cases Tools Help View Scheduling Reports Preop Quality Excellent Good Fair Poor Under testing Over testing C Replace Preop Supplemental Procedures Qty Description Alerts Beta Blocker Compliance Mat Met ee Wi nus Attending Times and Notes Start Time Stop Time Mate 8 31 07 se this is my attending note 14 27 RE 04 07 Del GC Name EIE IC T O10203 0405 Os De Assigned Case Level O Elective 010203 ng Was Level Appropriate O Yes No Current User 999 9 Data Last Refreshed at 09 13 on MU dy EA 6G diPR FEN Preop WU Comment Attending Preop Note E Add a New Row for Discontinuous Times Caze To Be Taken Over By View Problem List TEE Notes Exit Attending Notes 10 12 33 Postoperative Note Future Recommendations Enter a note into the Attending Intraop Note Field by typing directly into the box Start Time Stop Time Note 08 31 07 08 04 07 14 27 10 12 Del HE Name 138 Case To Be Taken Overby this is my attending nate am typing directly into this box Only the person who entered this note can edit it or delete id If there is someone taking over the case fo
86. irements will be far less to complete this case as it is not considered an OR Case You will receive a message to that effect if this box is checked Confirm Labor and Delivery Case Selecting Labor Analgesia Needed should only be selected for Labor and Delivery cases This will ignore Case times except For Anes Start and Anes Finish times Click OK iF you are sure vou want bo continue or Cancel to cancel E Enter Gestational Age in weeks in the appropriate box If appropriate check the box by Uterine Incision Required Enter a Uterine Incision Time by clicking the white box 125 E Case IT TLL IC gd he Lebo PRA hi A Heme LET NEM ETT LH bag Hd EE kg Be IL E bh E EX P m Environgent DEYO1 Vitals Co Ainvay Monitors Checklist Case Info Events P General OB Info D a F Labor Analgesia Needed Create C Section Case Anes Ready Une on egos Bot rer 3 C Uterine Incision Require EEE ect end neisian NES Fetal Gestational Age MIS mer Comments Dut Df Room i this area is for general comments pertaining to the OB section and other relevant fetal information e i did Anes Finish S Specific Birth Information Change User Infant Name APGAR APGAR Bitth Weight Time Of Placental Del ar Temp Mame 1 min 5 min Ibis Time Of Delivery Deliver Imm RN RN M Preview ath ELIT NEN Current User JoshTest Fellow
87. isoine araa a a a a a aa Aai aiai 79 Delete FIGS ernn LEE 79 Mime soume HII ICI LEUTEN 80 SEARCH FOR A DRUG sinian gas uEV a E saaE PEE Aa i Se e uacua iE E a a Maas SS EEME 81 ADDING A MEDICATION anciana 81 W ste d MECICACION i siacs sus sux sui uk nKuss uuu a 84 TOTALS TAB M anaE 85 SNOW DINOS MP EET LOI LIII ILI 85 SNOW PLUGS TETTE 85 FIUILO TOS as 86 COMMENT Sapine aana ID TUTTI ITI 89 EdIC COMMEN LITTLE 91 Delete COMMENUES ici Aid ANNE 92 QUICK COMMEN S T TI TITTEN 94 Add A New Quick Comment c2 ens eunuuauuuuuuuu uuu RRRRRRRRRRRRSRRRRRRSRRRRRRRERRSRRSERRSRRSERRSRRSSRRR 94 Use a Quick COImnmenLb ied vsvs oo Ei vuve cuan ex aeu ERE Sa a Mov E LEER RE DERE VE ERE CKMEEE ENERO 96 Edit a Quick C mmienEt iouis a eee adnd n 97 ANESTHETIC TAB Gic inessue vaasposusEve issu EM iE a a DER EDO ANA FARRRAVMN Ee IR cR ERA Reg eN EL nnne necs Sage aa ENS U ERE LE RUE 98 pu valere S 100 MONITORS TAB cirio can 102 CHECKLIST picem ae 105 e clle 106 DIAGNOSES pee 107 Ree e URP TNNT URER 109 JU do 0 y Po 111 Residents CRNAs and SRNAS c ccccoccoccooocococononnornncnnornnrnnornnrnnnr nr nr nnr rn rra 113 Attending AnesthesiologlSES cnica is 115 EVENTS co 116 O wem 116 Delete ARS a 118 DELAYS A accee vane ceeanpaeanacenceeupeeaumassmucnsewantec a a 120 esp ro
88. k Collect You may collect an entire set of vitals using this method e Click the Monitored button so that its heading appears above the vital sign legend Once you clicked Monitored the button will change to read Selected and the Clear Line button will change to read Collect e Next select the vitals that you would like to document NOTE You may select more than one vital sign using this method e Click on the Collect button under the checkboxes on the left panel as shown above e Finally click on the grid to document the vital sign listed at the top It will take you through all of the vital signs you have checked on the left panel 59 Comments Anes Ainway Monitors TEM Ease Info Events mm DB SCIP Ommen SNES Wal FORLOT L FIBokISE Late INTO L eni LEILAS OD 2LIFE E ee ILI T7 many roy I m L l Prk LS gine LVS ILS Ley uL st Le l nments Anes Away Monitors Checklist Case Info Events Delays DB SCIF Jj L at 1 60 Auto Collect l SLI hionitoned mv SM LT e Click the Monitored button so that its heading appears above the vital sign legend Once you clicked Monitored the button will change to read Selected and the Clear Line button will change to read Collect e Next select the vitals that you would like to auto collect NOTE You may select more than one vital Sign using this metho
89. k Next The rest of the scheduling feature will be the same as discussed below Points to remember v The case type you choose when beginning the import or scheduling process will determine the rights you have to edit patient demographic information Make sure you select the correct Case Type when using the Case Scheduling Wizard IMPORT CASE This function allows case information to be sent from ORMIS over to VPIMS Selecting this item requires keying information from ORMIS Select this option 11 VPIMSBaseC lasses Enter the case number of the case you wish to import fram the scheduling systern Case Number MRA Account Name Age Sched Date Sched Time Surgeon abi pena s Room VLIH3 RM 06 Procedures Trauma Exploratory Laparotomy Exploratory Celiotomy Puto Bx 5 Side 5pleen Level 1 0115 Status Scheduled IF this case was cancelled please reschedule the case as a new case in your scheduling system and try again If the case has already been imported you will get a message saying that the case has already been imported Import Case Information from Scheduling System The Following information was Found in the scheduling Far the scheduled case number vou provided Case Number MEM ort Account Mame gt 1d Age Sex Sched Date 4 11 2005 Sched Time 4111 2008 7 30 00 AM Surgeon rail ll Location Procedurers UNLISTED PROC DENTOALVEOLAR STRUCTURES Dad c Do vau wish b
90. k for myocardial ischemia suidlie The information on this page will be weed for mtemal Peer Fevrier only Cordiderdtial and privileged pursuant to the provisions of Section 63 6 219 of Tenressee Code Armotaed the contractual obligations of Vanderbilt Uruwersity to de ineurance compares the attonwy client privilege and other applicable prowisions of lam Answer the question by clicking in the appropriate box If more information is required it will display an additional question to answer below the question you just answered To view guidelines regarding the SCIP indicator click guideline 133 Vitals Comments Totals Anes Arway Monitors Checklist Case Info Events Delays OB CIP EMR Perioperative Patent Guidelines Y N Is this patient at significant risk for myocardial ischemia LJ UM The formation on this page will be used for tera Peer Renew only Cordidertial md privileged pursuant to the of Section 63 6 219 of Terrwssee Code Arnotated the contractual obligations of Winderbit Uwwereity to its Insurance comparues the attorwey client privilege and other applicable provisions of lar 3 https vpims mc vanderbilt edu Guidelines for Routine use of Perioperative Beta bl I a STANDARD OPERATING PROCEDURE DEPARTMENT OF ANESTHESIOLOGY VANDERBILT UNIVERSITY MEDICAL CENTER TITLE Guidelines for Routme Use of Perioperative B
91. launched on that workstation it might take longer than normal The application must be downloaded on the workstation 3 VPIMS Application Suite Microsoft Internet Explorer File Edit View Favarites Tools Help AN Ld Q es or E A JO sen 57 Favorites e A a Address E https Pvpims me vanderbilt edufypims vpimsapps asp Bc d Gn e x A login box will appear Log in with your VUNetlD and EPassword Login to GasChart e L O M If you do not have any late cases you will be told so at login time You do not have any Past Due ACRs at this time Initial Case List Screen Past Due Cases When you log into GasChart you might get a screen that looks like the one below with a red box labeled Past Due Anesthetic Care Reports This appears if you have not finished documentation on a case including the Attending Notes VPIMS GasChart Selection Screen Fi Edil Environment PIMS_ Test Daye Site Am Date Time Patient Procedures 3 253 VUH3 VUH3 02 01 2007 1300 500 a Y TRAUMA BURR HOLE S w EVACUATION t9 Pefresh Screen Past Due ACHs Preop Open Case Open Read Only Reports Attending Notes Change User 10 12 2007 a 10 12 2007 GazChart Current User Christie Todd D 10 To finish the case Click on the case and click the Open Case button To close the box Click on the x in the upper right of the red frame Buttons on the Right Panel see picture
92. ll button To see no sites or to clear your selections All Belg Environment DEYO1 Refresh Screen Past Due ACHs Preop Open Case Open Read Only Reports Attending Mates Change User My Profile Assign Rooms Exit GasChart button To see only the sites associated with your name click the My Rooms button Search by Site Aoom WUAS aL YUH3 AM 02 A TvVC3 PE VUH3 RM 03 MCE3 C VUH3RM O4 FEL4 C WUHS AM 05 VUHA C vUH3 RM 06 VCH3 C VUH3RM OF VLIHT C YUH3 RM 08 MCEG C UH3 RM 09 v Search by Site Hoam Search by SiteAoorm D 09 27 41 click the None My Rooms Car none CO UH3 A VUH3 A C YUH3 AM 02 ETTE M TvVC3 AMO YUH3 RM 03 C MCE3 MCE3 C VUH3 RM 04 FEL4 FEL4 VUH3RM 05 E vUH4 VUH4 L UH3 RM 06 E CH3 VCH3 LL VUH3 RM 07 C UH1 VUH1 C UH3 RM 08 MCEB MCEB VUH3RM 09 ALA bal 44 Select Rooms To select rooms to view within the site that is selected click on the rooms that appear in the room list for only the sites selected that you would like to see VPIMS GasChart Selection Screen Am RM 02 RM 02 RM 02 RM 04 RM 06 RM 06 Date 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 Time 07 30 10
93. lth issues documented for the patient in their Preop Evaluation if one is present Using a Template A case template may be created and used to start the documentation of a new case Cases thereafter may be opened using this specific template and all information stored in that template will be automatically inserted as documentation in your specific case You may create your own or copy and save someone else s template as your own 21 VPIMS GasChart Selection Screen File Edit View Site WCH3 Es WCH3 A vCH3 A vCH3 3 VCH3 VCH3 a Es YCH3 Es VCH3 Li VCH3 Es WCH3 E Search By Date 3 Today s Cases Scheduling Hm RM 12 RM 12 RM 13 RM 13 HM 14 RM 14 STAGE STAGE STAGE STAGE 2 Yesterday s Cases 2 Date Range Date 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 Cases 06 00 09 30 09 30 11 30 08 00 10 30 11 00 12 00 07 15 08 15 08 15 09 23 10 15 12 17 12 00 13 30 Search by Siter Aoom Reports Tools ajja Help Environment DEYD Procedures COMPLETE REPAIR TETRALUG T FALLOT 0 COMPLETE REPAIR TETRALOG FALLOT 4440 UNLISTED PROC DENTOALYEOLSR STRUCTUE UNLISTED PROC DENTOSLYEOLSA STRUCTLIF Refresh Screen Past Due ACR PALATOPLAS TY CLEFT PALATE ATTACHMENT REPLACEMENT REVISION CSF SHUNT DESTA Preop Open Case Open Read Only LAR YNGOSCOPY DIRECT wl TRA
94. m you are scheduling Key in the number and click NEXT If the patient was scheduled within the last 24 hours you will get a reminder with some additional documentation requirements ES CaseSchedulingWizard Elective Case ls this case a reoperation for the patient during the past 24 hours O Yes No Please select 4 reason for the reoperation If the patient was indeed scheduled within the last 24 hours click YES Otherwise click No to continue If you click YES you must select a reason for the re operation from the drop down menu Please select a reason for the reoperation Arway Complication Bleeding Delayed Primary Closure Hematoma Incomplete Procedure Ischemia Other Planned 2nd Procedure Then click NEXT Case Scheduling Wizard Scheduling OR Case Wizard Review the patient information below to ensure that you have entered the correct medical record number for the patient you wish to schedule and click Next IF the correct patient is nat shown click Back and verify that the correct medical record number has been entered MRN 1117 SSN M ame FML i zh Phone Address AN Test Birthdate Address 2 Tes Sex City St Zip Cancel x Back The next screen will ask you to confirm the patient information for the patient whom you are importing Make sure this information is correct If so click NEXT The next screen will require you to verify case details C
95. me Dose oem Route Interval Period Max Max Units Indication EEE im w we hoel e Pane o PACU Discharge HA Discharge Weight i kg Needed to calculate weight based dosage Discharge from PACU if pt meets the following criteria PACU Labs Other 1 Vital signs are within baseline range O ABG Glucose C Chest X Ray 2 Neurologic function has returned to preoperative status 3 Oxygen saturation at preop level Ci cec SMAG 12 Lead EKG 4 If foley present urine output normal PCY C Accu Check No Orders have been printed 5 Labs post op are normal or appropriate 6 Temperature is within normal or preop level Other NEN Other Save New Order Physician will assess pt prior to discharge C Discontinue 4 Line in PACU Hote O y YO PACU Comments Current User e Sea 08 56 29 E Please enter a name for your new Order You may create an order set by entering the desired orders on any given patient then clicking the Save Order button You will be asked to type in a name for the order set knee replacement Test orders 1 When you are finished naming the order set click OK You will see the order that you have just created appear in the Orders list under your user name To use orders from another provider To use another physician s order set select the desired user from the drop down menu When you select a user the names of their order sets will be displayed below their user
96. me T LAPAROSCOPY SURGICAL CHOLECYSTE Fiefresh Screen 03 14 2008 08 00 10 00 Wk cn EXCISIONAL PREP CREATION RECIPIENT Past Due ACRs 03 14 2008 08 30 12 30 i LAMINECTOMY 20 FACETECTOMY FOR 03 14 2008 13 00 14 00 Hase x CREATION SHUNT VENTRICULO PERITC 03 14 2008 08 00 11 00 ARTHROPLASTY ACETABULAR amp PRUIN Open Lase Preop Open Read Only 03 14 2008 08 00 10 30 u SELECTIVE CATHETERIZATION ARTERIA 03 14 2008 11 00 14 00 ha SELECTIVE CATHETERIZATION ARTERIA 03142008 08 00 12 00 ii i DIRECTZPATCH CLOSURE SINUS YENOS 03 14 2008 08 00 09 00 tes tod DEBRIDEMENT OPEN FX DISLOCATION 031422008 14 00 15 30 OFEN TREATMENT OF DISTAL RADIAL IN se gt Reports Attending Motes Change User hy Profile Refresh Screen _ _PastDueACRs o Pep _ Openase Open Read Only Reporte Attending Notes _ Change User MyProfile _ Assign Rooms Search by Site Hoom Search by Patient s Name Assign Rooms My Cases J EN L My Incomplete Cases GasChar Current User Christie Todd Data Last Refreshed at 10 21 10 21 13 Case Status Filter a q HB Qa a With either method you choose you will be prompted with a popup message CASE INFO VIEW CASE INFORMATION Use this to view additional information about the procedure or patient VIEW PATIENT DEMOGRAPHICS Use this to view the patient s demographic information name DOB gender etc VIEW PROBLEM LIST View the thea
97. name Select the order you wish to use and click Use Order 148 TA TA A ogg CLE SE re Postop Ord Sele File Edit View Scheduling Cases Reports Tools Help Environment DEYO1 Respiration Drug Allergies Place pt on 40 face tent for 30 mins then if 02 saturations are maintained room air at preoperative level discontinue 02 COMING SOONI L Place pt on ventilator and obtain ABG s in 30 minutes Rate ME Peep ME Tv HB 02 EM Pressure Support H PACU Meds Med Name Dose Dosage Haute Interval Period Mas blas Units Indication O noten lA m v ous fos res CI CN 1 S TT ee a a a PACU Discharge HA Discharge Weight kg Needed to calculate weight based dosage C Discharge from PACU if pt meets the following criteria PACU Labs Other 1 Vital signs are within baseline range l C ABG C Glucose C Chest Ray 2 Neurologic function has returned to preoperative status 3 Oxygen saturation at preop level Ci cec C SMAG 12 Lead EKG 4 f foley present urine output normal C PEY C Accu Check No Orders have been printed 5 Labs past ap are normal ar appropriate E b Temperature is within normal or preop level Other po Physician will assess pt prior to discharge Wen i xXx C Discontinue A Line in PACU Orders ET Adult Ao e FALL CUM NENNEN Current User e o e 08 54 51 To save another user s order sets for your own use To save another provider s order s
98. ndard information 100 Vitals Comments Anes Airway Monitors Checklist Case Info Y Events Y Delays OB 09 46 Airway Mask DL 09 04 C Supplemental oxygen only Easy C Easy C Atraumatic mE mem Moderate Moderate Traumatic Mask only inway Oral O Difficult Difficult Incision amp O un Onsa Elise E Impossible mo i i N A d cm c view Gide Ot 02 O3 O Ot JE decom T m mnived Intubated Arved Trached l L Successful Blade Dut Of Room Intubated in DR bu Anesthesia staff se Mileit O0 O1 02 03 O4 Canes Finish E Oral C Nasal C Trach Wer Oo O1 O2 Os O ENE E Direct Laryng C Lighted Stylet C Blind WHE 015 C In Line Stabilization C Awake AS E B E Standard Size Taped lem Attending Notes CiO 4 21 Rai Rc Laser Stylet Leak 23 mmg Postop Orders C Anode C Uncufted Preformed RAE C Dbl Lumen Size Taped lem L Comment Once you complete the mandatory fields and click off the tab the red exclamation point will disappear no C Jet Vent more mandatory information on this page If there is a text field where notes can be entered you will see a d icon If you click on this icon you will be directed to the quick comments page If you have saved quick comments you can use those to fill in the text box Or you can just type in the text box without clicking the d icon VPIMS
99. ntrols OFF Machine Leak Test OK 02 Monitors OK Scavenging System ON HARABE You can also add comments in the bottom white comments box at the bottom of the screen If there is a text field where notes can be entered you will see a d icon If you click on this icon you will be directed to the quick comments page If you have saved quick comments you can use those to fill in the text box Or you can just type in the text box without clicking the d icon 105 Case Info Click on the Case Info tab to open the case information Lem TE anes eae e Les JE Low s General Case Information DressingOn acano A A is Room DUM Bes Finish E Comments Comments 3 14 2008 Times 13 00 16 00 Prep Breaks Scheduled Attending E l Start Time Stop Time COMM tending Motes Primary Att per Resident Shark T ime StopTime Note me 03 14 08 10 28 p Note Attending Anesthesiologists Residents CHHAs and SHNAs F have received a preoperative hand off report including patient identification and status of blood product and medication xl ase 106 Diagnoses Diagnoses are pulled from Patient Tracker information If you need to change or add this information click on the Edit Diagnoses button A new window will pop up Click on the fields in the boxes to narrow your search When you find the diagnosis then double click on it It will then appear in the list of dia
100. o import this information into the case being scheduled Case Scheduled A Your case is now scheduled LIST CASES NOT IMPORTED 12 This function allows you to manually link a case that has been scheduled in an outside scheduling system Select this option Case Scheduling Wizard Double Click on a record to import the case MedicalRecord LastName FirstName SurgeryD ate Location 4 11 2008 NSC RM 04 4 1 2008 VCH3 RM 15 4 11 2008 VLIH3 RM 16 If there are cases that have not imported to VPIMS they will be displayed on the next screen Double click the case you wish to import Import Case The Following information was found in the scheduling For the scheduled case number you provided Case Number MIRA Account Mame Age Sched Date Sched Start Time Sched End Time Surgeon Location Procedures Anesthesia Required Isolation Precautions Would you like bo import this case A demographics screen will appear Verify that the information displayed matches the patient you want to import and click Yes The following screen contains read only demographic information Verify that the information is correct If so click Next If not refer to your department s policy for editing medical record information 13 Case Scheduling Wizard GaselScheduling OR Case Wizard Review the patient information below to ensure that you have entered the correct med
101. o use Available Quick Comments VPIMS Marker Test Comment Insert Comment Edit Quick Comment Insert Current Time Create Quick Comment The comment should appear in the text box Event Marker for 11 05 Current Text Available Quick Comments This iz the test of my VPIMS Marker test comment use this WPIMS Marker Test Comment field to designate any significant times during the case Insert Comment Edit Quick Comment Insert Current Time Create Quick Comment 70 Edit a Quick Comment To edit a quick comment click the name of the comment you wish to edit Then click Edit Quick Comment Available Quick Comments tg deflated tg inflated WPIM5 Marker Test Comment FEA A A Insert Comment Edit Quick Comment Insert Current Time Create Quick Comment A new window will open with the text of the selected comment Make any necessary edits Edit Quick Comments Quick Comment Name VPIMS Marker Test Comment Quick Comment Text This iz the text of my VPIMS Marker test comment just edited it Then click the OK button and your changes will be saved 71 Editing a VPIMS Marker To edit or delete a marker you already entered find the marker on the grid and right click it v Delete Marker Y Py T Y I de Y L Edit Marker o Cancel Po 59 09 0 5 0 0 5 0 x X X x X XM x x X i x xXx im oy vw v Y ow Pe ow ow v T o YY wee AA Aca A AhaAhT n ij To edit click edit marke
102. oday s Cases Yesterday s Cases 2 Date Range from 08 05 2008 v im 08 05 2008 My Cases VUH3 TvC3 MCE3 FEL4 VUHA VCH3 VvUHI MCEE Case Info Date 08 05 2008 08 05 2008 08 05 2008 08 05 2008 08 05 2008 08 05 2008 08 05 2008 08 05 2008 08 05 2008 08 05 2008 08 05 2008 06 05 2008 wt Template Time 07 30 08 30 inmsa hn 07 30 09 00 09 30 11 00 12 00 13 30 14 00 15 00 15 30 17 30 00 30 01 30 07 30 09 30 10 00 12 00 10 30 11 30 12 00 13 00 07 30 11 30 Tools Help Patient LIMIT Procedures REMOVAL PERMANENT INTRAPERITONE REMOVAL TRANSPLANTED RENAL ALLO ARTERIOVENOUS ANASTOMOSIS OPEN SPLIT THICKNESS SUTOGRAFT FACE GE EsCISIONAL PREPACREATION RECIPIENT SPLIT THICKNESS SUTOGRAFT TRUNKS INCISION amp DRAINAGE COMPLE POSTO DEBRIDEMENT SKIN amp SUBO TISSUE SII DEBRIDEMENT SEIN amp SUBO TISSUE SII REPLACEMENT REVISION YENTRICULO INSERTION SUBO RESERYOIR PUMP INI IMPLANTATION MESH PROSTHESI5 INC se gt ITI K Search by Patients Mame C YUHS RM 03 VLIH3 RM D4 VLIH3 RM n5 VLIH3 RM DB C VLIH3 RM OF C VLIH3 RM 08 C VLIH3 RM 09 Semen J Oe Case Status Filter nome D A E wr My Incomplete Cases Current User Christie Todd Data Last Refreshed at 09 26 To see the cases for all sites click the A
103. om the drop down list If you do not wish to use a template for your case you may click the Cancel button 47 Verify and Sign In to Selected Case MRN ORCase ACN Hace Sex Female Weight kg DOB 02 25 1946 62 2 urs s c performing Exploratory Laparotomy Exploratory Celiotomy Who Bx S Sep Proc YUHS AM 02 0470772008 1200 1 4 00 have received a preoperative hand off report including patient identification and status of blood product and medication Infusions Please verify the patient information above Enter necessary information and click DK to open this case and sign in otherwise click Cancel to return to the patient selection menu Sign In Date Time 04 07 2008 v 10 06 Anes Start Select a Template from your own collection or someone else s Press Lancel Do Not Select Template If You decide not to apply any template to this case as vou oper it PEDI HEART Cancel Do Mat Select Template THORACIC You will also be asked to enter a time The default time is the current time and date Choose Anes Start if you are entering the case at the Anes Start time To refresh the time to the current time and date click Now Choose Now if there will be someone else also signed into the case with you Choose Relief if you are replacing someone in that OR When you are ready to open the case click OK 48 LOGGI NG IN IF YOU A
104. on can be used to get the current information for this screen from the database The screen automatically refreshes as well 2 Past Due ACRs e This button can be used to see incomplete cases you are associated with they will also show as incomplete if the Attending hasn t entered their note e Close this window by clicking on the upper right x of the red box e For more detail see section on the previous page 3 Preop e This button will pull up an electronic Preop record if available for the case 4 Open Case e When a case is clicked on in the case list then this button will become active 2 e Single click on this button to open the highlighted case e See more information on this button in the Chart In A Case section of this document 5 Open Read Only e When a case is selected you can single click on this button to open the case in Read Only mode not editable and you will not be signed into the case 6 Reports e Click this button to view a print preview of the available reports for the case highlighted e Click the x at the top of the document to get back to the main page screen 7 Attending Notes e Click this button to go directly to the Attending Notes section for the case that is highlighted e See Attending Notes section of this document for more information 8 Change User e This button may be used to log off and bring the login screen back up for someone else to log in
105. ped cm L O2 03 04 O2 03 04 Clear iit Document desired information in the Airway tab for your template For more information on the Airway tab refer to that section in this document 29 Monitors Drugs Fluids Lower Grid Anas i Checklist i std GA Std Reg M L Std LMA Invasive Monitors Location Gauge A O0 Arterial Lines Other Monitors C TEE L Evoked Potential O Other Placed Anesthesia Placed Document desired information in the Monitors tab for your template For more information on the Monitors tab refer to that section in this document 30 Checklist Drugs Fluids Checklist Supplemental Checklist 02 Failure Alarm OK Essential Check Unused Controls OFF Cylinder Pressure OF Pipeline Gas Press OF Gas Flow Controls OFF Machine Leak Test OK 02 Monitors OF Scavenging System ON Systems Check Comments cj Document desired information in the Checklist tab for your template For more information on the Checklist tab refer to that section in this document 3 Case Info Drugs Fluids Lower Grid nes ANS Monitors Checklist Case Info Diagnoses Procedures Code Description Code LongDescription Del Surgeon ae v Comments Comments II Del Start Time Stop Time Start ime Stop T ine Solo ce MAA Add a Mew Row for Discon
106. r maker any textual changes and click OK Deleting a VPIMS Marker To delete a marker you already entered find the marker on the grid and right click it V Delete Marker Voy V Y y Y Y 1 v A Wi Edit Marker o Cancel D Oo 500005022502 X x X X 4 w x x x X A X x x Yo Y 7 Y gt y Y F F y Y Y o AA A LA Ah aA T t Click delete marker Verify your deletion Points to remember v If you add a VPIMS marker but do not enter any text associated with it it will appear on the grid as a red star Markers with text appear as blue stars 72 Lower Grid Documentation Adding Vital Parameters To add a specialty vital parameter for documentation click the Vitals label on the left of the screen L5 10 20 Atala Filter 2 A new box will pop up Click the checkbox next to what you want to add When you are done adding parameters click the OK button Available E Parameter Des x ECG ED Et Agent 4 Et CO mmHg Et Des Et Hal X Et so X ISTE ISTESIE TET ISTIS Edit Parameters Available Selected I Parameter LowerGrid ACT ECG BE Temp L BIS Des X Cal 02 I m Cern Left Aur l m Cens Right Fide Cl Et CO2 mmHg Co Et Des 5 CF v Made DOCCT Edit Selected Parameters for All Lower Grid The selected item s will appear in the lower grid so the user can enter information 73 Vital Resp Anes
107. r in the grid with the dose you entered If you have a templated drug listed in the particular case you are documenting you will be unable to delete the drug name 82 Edit a Medication To edit or delete the dose of a drug click on the appropriate dose in the appropriate box that you wish to edit Edit cefazolin gm Div Pharm Sur Surg Dose Disp Reg Admin O ammo yw OOo Del Time Doze Route cefazolin qm The dosage window will pop up The time and date will be displayed If the time and date are incorrect you may change them by using the same process for changing times as was discussed earlier in this document Make any necessary corrections and click OK To add a secondary drug dose in the same time frame click Add Dose Follow the same steps as above for entering the new amount Delete a Medication To delete a drug dose click on the drug you wish to delete in the correct time frame you wish to delete Click the Del checkbox by the dose you wish to delete When you are done choosing doses to delete click OK Edit fentanyl mcg Diy Pham Surg Surg Dose Disp Reg Admin Tp eee ss wy OOo o OR ovas so mv D DB D Del Time Doze Route fentanyl mcg The grid should recalculate and subtract your deletion appropriately cefazolin gm fentanyl mcg Waste a Medication Vials opened from the anesthesia cart and not used are recorded as waste Unused portions o
108. r you choose their name from the Case To Be Taken Over By dropdown Del QC Mame Start Time Stop Time Mate of 083107 0904 07 this ds my attending nate am typing directly into this box Only the person who Thee 10 12 entered this note can edit it or delete it Click on a button to select the Assigned Case Level Click on the radio button to designate if case level was appropriate or not Next click on the appropriate ASA score button Click on the Exit Attending Notes button to exit this section Attending Notes AERE Pa EU ee ge A M IIIS x lax u File Edit View Scheduling Cases Reports Tools Help Environment DEYO1 Supplemental Procedures Preop Quality Preop WU Comment Qt Description Excellent Good Far Poor r f C Under testing Over testing C Replace Preop Alerts Attending Preop Note Beta Blocker Compliance Mot Met Anes ime 7 Attending Times and Notes Add a New Row for Discontinuous Times Case To Be Taken Del OL Name Start Time Stop Time Note Over By 3f Sm we 2 21 07 09 04 07 this Is my attending note am typing directly into this box Only the person who a vl 14 27 10 12 entered this note can edit it or delete it m ASA Postoperative Note Future Recommendations eee e ee EUM Ire Assigned Case Level Elective 010203 View Problem List Problem List Was Level Appropriate TEE Notes Trainee Yes No Exit Attending Note
109. rrent patient with new case numbers for the impending Cesarean case When this button is clicked a new window pops up where the user must input case data NOTE This tab is used if the patient s Labor and Delivery was already scheduled and underway but then turned into a Cesarean Section 130 General OB Info Labor Analgesia Needed Create C Section Case Uterine Incision Required Low is Click to Create new C Section Case Fetal Gestational Age 1 weeks Comments Specific Birth Information Infant Name APGAR APGAR Birth weight or Temp Mame imn 5min Ibs Time Of Placental Time Of Delivery Delivery C Section The Anes Finish time will now be entered The user must input all fields on the Create Cesarean Case form This information along with the generated case numbers is the only non reused fields from the L amp D Case When the case Is created the Anesthesia finish time for L amp D case is automatically entered and the case then gets locked and printed If there are missing items in the case the case will not lock and print Upon completion of all required items in the current L D record the user will be asked if he she wishes to send the report to Star or just exit the case 131 Case Complete Summary of Errors and Warnings Case Complete Errors A No Errors Case warnings The following Case Times have dates
110. rself from a case completely click the clear button next to your name You will be asked to verify the deletion 113 Case Info Events Y TM OB gi A Diagnoses Procedures Surgeons Code Description Del Surgeon F 222222222222 Remove Signature and Exit Case Vitals Totals Comments d Anes envia TT fo anes Ready ie ei Code LongDescription weight kok S Attending Anesthesiologist Residents CANAs and SANA Scheduled Attending Do f Del Mame Start Time Step Time Primary Att per Resident come 03 14 08 10 29 Note Check Case Preview ACA Print Reports Ready for Attending Exit Case l Add a New Row for Discontinuous Times F Infusions Business Rule There must be a Resident CRNA or SRNA assigned to the case or the Solo Attending box must be checked 114 Attending Anesthesiologists You may view the attending notes using this box The notes are not editable here If you are an attending working alone on a case check the box next to Solo The current time and date will be documented automatically You can change the time and date by typing in the space provided Vitals Totals Comments Anes Sirera Monitors Checklist YY Case Info Events Delays DB Anes Start 10 36 Mu Wal
111. ry Date 2 06 2007 Patient aahi LLE Start Time 2 6 2007 7 30 00 AM MRE ei po mt Surgeon Jose Diaz Jr Procedure EXPLORATORY LAPAROTOMY EXPLORATORY CELIOTOMY W W BX 5 SEP PROC PROCTOSIGMOIDOSCOPY RIGID Dx SEP PROC CLOSURE ENTEROSTOMY LARGE SMALL INTESTINE EXCISION EXCESSIVE SKIN amp SUBO TISSUE INCLUDES ETE Who requests that the case be cancelled PEI Cancelled By Patient we Reason Patient choice t Comments Type any comments here VPIMS GasChart Selection Screen File Edit View Scheduling CaseInfo Template Reports Tools Environment PreTest_N Date 037142008 03 14 2008 03 14 2008 03 14 2008 03 14 2008 03 14 2008 03 14 2008 0314 2008 0314 2008 03 14 2008 03 14 2008 Time 08 00 12 00 12 30 14 30 08 00 10 00 08 30 12 30 13 00 14 00 08 00 11 00 08 00 10 30 11 00 14 00 08 00 12 00 08 00 09 00 14 00 15 30 Fatient Procedures rh ERFLU RATUR T LAPARUTUM ESPLORA LAPAROSCOPY SURGICAL CHOLECYSTE ESCISIONAL PREPYCREATION RECIPIENT LAGMINECTOR Y WO FACE TECTOMY FOR CREATION SHUNT YVENTRICULO PERITC ARTHROPLASTY ACETABULAR PROIN SELECTIVE CATHETERIZATION ARTERIA SELECTIVE CATHETERIZATION ARTERIA DIRECT ARATCH CLOSURE SINUS VENUS DEBRIDEMENT OPEN Fs DISLOCATION OPEN TREATMENT OF DISTAL RADIAL IM se Refresh Screen Past Due ACH s Preop Open Case Open Read Only Reporte Attending Notes Change
112. s Current User te o Data Last Refreshed at 09 13 C 10 25 20 139 The attending note now appears in the Case Info tab in the attending notes section To view click Note Cao maim e co tt Ma ba t i M NB ia nca EX File Edit View Scheduling Cases Reports Tools Help Environment DEYO1 ITE Diagnoses Procedures Surgeons 1009 2 Cade LengDessipin A CAMA m7 NS com e General Case Information DressingOn Acct Ma OO0000000 0000 Out Of Room f 10 09 2 udi SAA pes Finish Co if Attending Notes for Todd Christie Es A Change User E Hop Breaks Scheduled Attending op Time eal Attending Notes Primary Att per Resident Mame StartT ime Todd Ch a 08 31 07 14 27 Solo 02 06 2007 10 10 Add a New Row for Discontinuous Times Current User Data Last Refreshed at 09 13 C 10 27 34 Business Rule If the Attending Notes Section is opened the ASA Classification Case Level and Case Level Appropriate fields must be completed before the user can exit 140 TEE Notes To document a TEE Trans Esophageal Echocardiogram you must be an attending or fellow working as an attending In a case and signed in as such in Gaschart The TEE button is located within the Attending Notes tab EE Attending Notes for demo Wpis Fher OP Magee Ej ae Da EU ee ogg A eh Ge riba Cc fel oJ File Edit View Scheduling Cases Reports Tools Help Environment DEYO1
113. s e This section allows the user to document many different vital sign types e Clicking the label on the left of the screen will open a popup for adding parameters case specific vital sign types e The functionality of this button will be discussed later in this document BJ 11 Fluids e This section allows the user to document fluids and rates during the case e Clicking the label on the left of the screen will open a popup for adding a fluid to the list e The functionality of this button will be discussed later in this document Documenting Vitals Manually Click on the symbol on the left panel that you would like to chart Make sure the heading at the top says Selected Note You can only document one vital sign at a time using this method 10 45 Selected Scale Get Past 5 Molol T Then click on the grid where you would like to document that vital sign The chosen vital sign in the box below is heart rate represented by a heart 58 Case for Wike II O AA I File Edit View Scheduling Cases empale Reports Tools Help Vitals Totals Comments Anes Ainvay Monitors Checklist Q Case Info Y Everts i Delays OB SCIP EMR Er Scale Get Past 100 tals Filter vital Resp nes att me 5 Current User eee gt Data Last Refreshed at 10 45 Then you can click another symbol and click on the chart to document it Repeat as necessary Quic
114. s if available Clear Edit Signature Then click the OK button to save your signature 41 Assign Rooms This feature allows the pre population of staff into rooms without having to open each case individually and enter staff TS GasChart Room Assignments BAR File Fie Edit view scheduling Cases Template Reports Tools Help Environment PIMS_Test Display Room Assignment UserName Select Date 12 13 2007 w Default ite Role Li TICU 4 Altending TwC3 Po Billing Coordinator 3 C CH3 Coordinator 9 7 vPEC CANA CI UH1 H Fellow MITE Ier m Help Desk Tech Suppo s Aaron Tammy Abraham Emnet Nurse 0 Acree Glenda Radiology Tech 0 Acrey Alison Circulator 0 Adams Anne Nurse 0 Adams Cheryl ciciler 0 Adams Cheryl Scrub 0 Adams Heather Procedure Co n 3 n Adams Robert Nurse mag LU amp l x xslesxx x ex e e To use this feature first select the site for which you would like to make assignments DefaultSite e Your default site the site designated in your access is checked by default You may also check additional boxes to view other sites v To view all sites click All Y To erase all checkmarks click None 42 Role Attending Biling Coordinator Coordinator CRNA Fellow Help Desk Tech Suppo gt e Next select the roles which
115. section and other relevant fetal information You cannot enter future times Future Times Not Allowed Future times cannot be entered Time will not be updated If a Uterine Incision Time is documented and the user deselects Uterine Incision Required the following warning will appear Erase Uterine Incision Time A Unchecking Uterine Incision Required will erase Uterine Incision Time Are you sure you wish to make changes 127 Clicking Yes will uncheck Uterine Incision Required and will erase the Uterine Incision Time Clicking NO will cancel out of the operation and return the user to the OB screen leaving the data as Is Specific Birth Information The Specific Birth information section is for documentation on the individual infant birth s In the case of multiple births additional records can be added To add new infant information click on the white box under Infant Name and begin documentation Specific Birth Information Infant Mame APGAR APGAR ee Time Of Delivery Time OF Placental or Temp M ame mn A min Delivery Document the Infant Name or temporary name in the first box This can be the infants name if known or some identifying label to help identify the infant especially in the case of multiple deliveries For this example we will just use TEST BABY A NOTE INFANT NAME is a mandatory field Specific Birth Information Del Infant Mame
116. ted here if necessary ANESTHESIA REQUI RED The information imports from the ORMIS scheduling system It can also be edited here if necessary ADDING COMMENTS TO THE PROCEDURE You may also add comments to the procedure and edit surgeon information To edit surgeon information click the drop down arrow by Surgeon and select from the list To edit the procedure click inside the white box to the right of PROCEDURES and type in the desired comments To accept the new changes click DONE CHANGI NG THE LEVEL OF A CASE f a case is scheduled as a Level One Two Three or Four and that designation no longer applies or has changed you may change the level of the case by clicking the drop down arrow by CASE LEVEL and selecting the desired information A description of the different types of leveled cases is provided for you in the list Note In order to gray out the CONSENT SIGNED and H amp P INCLUDING VPEC WORKUP fields in the PREOP HOLDING CHECKLIST you must also designate the case a Level One Trauma case either by using the case scheduling wizard explained previously or by changing it here CANCEL CASE A window will pop up asking for information about why the case is being cancelled Select Cancelled By and Reason from the drop down list Enter any comments by typing in the space provided To exit without saving click Undo Changes 18 Case Cancelled The following case wil be cancelled ORCase uc Surge
117. that are more than 2 days AFTER the date of surgery 02 06 2007 Anes Start A 09 04 2007 06 10 In Room 097042007 08 13 Anes Ready 09 04 2007 09 73 Incision 09 04 2007 09 13 Closing 09 04 2007 09 13 Dressing On 09 04 2007 03 13 Qut OF Room 09 04 2007 09 13 Anes Finish 09 04 200 09 73 This case appears to be complete with warmings Do you wish to submit the ACR to StarChart and lock case from further edits Ho Just Exit the Case Yes Send to StarChart The user will then be prompted to create a new C section case Create Cesarean Case 4 Z Enter new times and or room in the panel labeled C Section Times and Room to schedule case L C Section Times and Room Start Time 1 04 2007 w 1313 Site VUH3 Stop Time 09 04 2007 v 1413 S Room Non OR Procedure Cesarean Delivery Create Cesarean Case Cancel If the user attempts to go into the old L amp D case he she will be locked out from editing the case The OB tab will display Cesarean Case already created General OB Info Labor Analgesia Needed Uterine Incision Required C Ss Cesarean Case already created Fetal Gestational 4ge weeks Comments Create C Section Case 132 SCI P Click on the SCIP tab to document SCIP information Vitals EIE jaral Anes pem Monitors Checklist ms Info Events Delays OB SCIP EMR Perioperative Patient Guidelines Y N Is this patient at significant ris
118. the errors noted above If items are missing or incomplete they will appear with a 152 red X next to them These items must be completed in order to send the case to StarPanel Case Complete Errors The following times are required Anes Finish Att Mates Atleast one attending has not entered an Attending Note Case Into No resident signature and case not marked SOLO Case warnings will appear with a yellow Exclamation point next to them These items are reminders or alerts for unusual information They are not required Case Warnings 06 18 2007 13 07 In Room 06 18 2007 13 07 Anes Ready 06 15 2007 13 11 Incision 06 1 822007 13 11 Closing The following Case Times have dates that are more than z days AFTER the date of surgery 02 06 2007 Anes Start 06718 2007 13 11 Dressing On 06 82007 13 11 Out OF Room 06 18 2007 13 11 If all mandatory fields are filled in then you will get a case complete message You may choose to Send the Case to Star Exit the Case or Cancel and go back to the Case Case Complete Summary of Errors and Warnings Case Complete Errors CG Mo Errors Case Warnings c Ma warnings Thiz case appears ta be complete Do vou wish to submit the ACA to StarChart and lock case from Further edits Mo Just Exit the Case Yes Send to Star hart 153 Exit Case To exit the case click the Exit Case button E Check Case II AI ___ Pr
119. tinuous Times Document desired information in the Case Info tab for your template For more information on the Case Info tab refer to that section in this document Note There are items on this page that are grayed out These grayed items are patient specific items and therefore cannot be templated When you are done editing the new template click Exit Template Copy Someone Else s Template To copy a template you must first select the user whose template you wish to copy Under Template select Copy 32 VPIMS GasChart Selection Screen Cases Template Reports File Edit View Search By Date Today s Cases C Yesterday s Cases 2 Date Range from O2 06 2007 to 02 06 2007 My Cases My Incomplete Cases Scheduling Date 02 06 2007 02 06 2007 02 06 2007 02 06 7200 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 06 2007 02 00 09 30 09 30 11 30 heel atn 08 00 10 30 11 00 12 00 07 15 08 15 08 15 03 23 101531217 12 00 13 30 Search by Site Hoom MCEB Current User Christie Todd Data Last Refreshed at 12 23 Tiis PPE e My Rooms Tools aak Help Environment DEWI Procedures COMPLETE REPAIR TETRALOGY FALLOT WO COMPLETE REPAIR TETRALOGY FALLOT WO UNLISTED PROC DENTOALYEOLAR STRUCTUF UNLISTED PROC DENTOALYVEOLAR STRUCTUF Refresh Screen Past Due ACH PALATOPLASTY CLEFT PALATE ATTACHMENT REPLACEMENT REV
120. tive status 3 Oxygen saturation at preap level Cec SMAG 12 Lead EKG 4 f foley present urine output normal C PEY Accu Check No Orders have been printed 5 Labs post op are normal or appropriate 5b Temperature is within normal or preop level Other DL 5 1 Other Physician will assess pt prior ta discharge MA Todd Christie C Discontinue A Line in PACU low SSS PACU Save Order Delete Order Current Useri o o Using the mouse click the buttons by the desired orders Respiration Ventilator Settings To enter specific ventilator settings click on the white boxes by Rate Peep TV 02 and Pressure Support and enter the appropriate numbers by typing them Other To enter other specific orders related to Respiration click the button by Other Click the white box to the right of Other and type the specific information you wish to have displayed PACU Meds To enter a medication order for a patient click the drop down menu and select a drug You may either scroll down the list to find the drug or enter the first few letters of the drug s name and narrow your search 145 Respiration Drug Allergies Place pt on 40 face tent for 30 mins then if 02 saturations are maintained room air at preoperative level discontinue 02 COMING SOON C Place pt on ventilator and obtain AEG s in 30 minutes Rate El Peep E TV dB OF Pressure Support a PACU Meds Med Name Dose
121. uation System Enter all of the requested information below and then press the Submit button Any incomplete entries will be discarded Your evaluation will be kept anonymous HELP About This button allows the user to see what version of the application is running My Profile Capturing or Changing Your Signature On the first screen after login click on the My Profile button to change your personal settings VPIMS GasChart Selection Screen Seles File Edit view Scheduling Case Info Template Tools Help k Environment DEWO Date Time Fatient Procedures A 08 05 2008 07 30 08 30 Wee he REMOVAL PERMANENT INTRAPERITONE DB 05 2008 07 30 09 00 es e REMOVAL TRANSPLANTED RENAL ALLO Refresh Screen 08 05 2008 09 30 11 00 lee c ARTERIOVENOUS ANASTOMOSIS OPEN Past Due ACAs 09 05 2008 1200 1330 fe SPLIT THICKNESS AUTOGRAFT FACE GE 08205 2008 14 00 15 00 cose fee EXCISIONAL PREP CREATION RECIPIENT peop 09 05 2008 15 30 17 30 deem Wwe SPLIT THICKNESS AUTOGRAFT TRUNK Open Case 08205 2008 00 30 01 30 W INCISION amp DRAINAGE COMPLEX POSTO Open Read Only 08 05 2008 07 30 09 30 Wie c DEBRIDEMENT SKIN amp SUBO TISSUE SII a 08 05 2008 10 00 12 00 ee DEBRIDEMENT SKIN amp SUBO TISSUE SII 08 05 2008 10 30 11 30 Tues sam REPLACEMENT REVISION VENTRICULO 08 05 2008 12 00 13 00 e ai INSERTION SUBO RESERVOIR PUMP INI 06 05 2008 07 30 11 30 ose co IMPLANTATION MESH PROSTHESIS INC se gt Reporte Atten
122. uling Cases Reports Tools Help Environment DEVO1 Date Procedures 02 06 2007 13 CHANGE GASTROSTOMY TUBE 02 06 2007 Emergency Vascular Trauma Cart Repair of Aaa 02 06 2007 13 15 18 30 ns My copy of Josh Resident s template 02 06 2007 08 00 09 30 en My First template Past Due ACRis 02 06 2007 09 30 11 30 Radi ATA Preop 02 06 2007 08 00 10 30 se sew PALATOPLASTY CLEFT PALATE ATTACHMENT 02 06 2007 11 00 12 00 se sem REPLACEMENT REVISION CSF SHUNT OBSTR Open Read Only 02 06 2007 07150815 s LARYNGOSCOPY DIRECT WAVO TRACHEOSCC Aul 02 06 2007 0815 0823 w de CREATION SHUNT VENTRICULO PERITONEAL Attending Notes 02 06 2007 10 15 12 17 OPEN TREATMENT RADIAL amp ULNAR SHAFT F gt s gt Search By Date Search by Site Room Search by Patient s Name Change User J O Today s Cases My Profile Yesterday s Cases C VUH3 RM 03 NN Date Range VUH3 RM 04 C VUH3 RM 05 from 02 06 2007 VUH3 RM 06 to 02 06 2007 E VUH3 RM 07 i Bran Cieza MCE6 C VUH3RM 09 My Incomplete Cases My Rooms GasChart Current User Christie Todd Data Last Refreshed at 12 38 O 12 38 25 lt To delete an existing template select Template then Delete then the name of your template that you wish to delete You will be asked to verify the deletion REPORTS Print Reports Selecting this feature will direct the user to the Print Reports screen TOOLS Click Tools along the top menu
123. user TEG Rapid Infusion System C Hemacue Cereb Ova Monitor R Balloon Pump Cereb Ova Monitor L L AD ltm std GA Std Reg MAC Std LMA E o Location Gauge Do Del Location Arterial e solo i Lines Location le Other Monitors m TEE O ICP Evoked Potential Fi Po A Anesthesia Placed Other Placed TISTISTISEIS IL TEL HSEISITS Std GA Std Heg MAL Std LMA 104 Checklist Tab Click on the Checklist tab to view and edit the checklist information The purpose of this screen is to document the essential and supplemental equipment checks You may click on the Essential Check button Checklist Case Into Supplemental Checklist Essential Check Essential C RI Ek 1 Supplemental Check 2 Failure Alarm OK Unused Controls OFF Cylinder Pressure OF Pipeline Gas Press OK Gas Flow Controls OFF Machine Leak Test OF 02 Manitar s OF Scavenging System ON Or you may click the Supplemental Check button Checklist Case Info Events Essential Check 012 Failure Alarm OK Unused Controls OFF SSCs Cylinder Pressure OF gt Pipeline Gas Press OF E Gas Flow Co
124. vious TEE will be copied over so the user can chart by exception Example 1 The first post bypass TEE will be numbered 2 post meaning it is the second TEE performed in the case but is a post bypass TEE The values from the pre bypass TEE will be copied into this new form upon opening it Example 2 The second post bypass TEE will be numbered 3 post meaning it is the third TEE performed in the case but is a post bypass TEE The values from the immediately preceding TEE will be copied into this new form upon opening it To Enter Data in the Grid area Click on the first column any box to select values See screenshot below Once the value is selected for the first column for any box the box immediately below can be copied by clicking on it To change the value click again and choose the appropriate value TEE Data Entry Pre Post ByPass Select TEE to edit 1 Pre M Add New TEE Delete Selected TEE teral Inferior Anterior nterozeptal Posterior Basal Mid Apical Please select a value for 1 Nomal Mild hypokinesis 3 Severe hypokinesis 4 Hypokinesis S Dyskinesis Basal Mid or Apical raw above Wall Motion LWEF 555 susp Phameres M Pacemaker 2 Comments Mu ple Right Ventrcle Assessment Normal vw Aorta Ascending Normal 3 Diam cm Grade Fla 3 Transverse Normal Fe Diam cm P Grade Fla Descending Normal a Diam em j
125. you would like to view eg SRNA Tech etc v To quick select all Anesthesia roles click the Anes button v To quick select all Nursing roles click the Nursing button v To quick select All roles click the All button e Next assign staff members to a particular room by highlighting their name and dragging it to the desired room v When you assign a staff member to a room their name will display in the slots for that room v n addition the count for MyCount the number of times they are assigned will increment See example below Name Role Sorrel Toney SANA Sorell Anthony SANA Spain Travis Tech Springhetti Laura SANA Sripada Rampr Attending SRNATest Rob SRNA St Jaques Paul Attending UserName el o SRNATest Rob Staack Jeff Resident Stafford Gwen Tech e To delete a staff person from an assigned room click the red X next to their name 43 Select a Case Search by Site The Main Screen is called the Patient Select Screen The center box lists all cases particular to the filters you have selected To select the site for which you would like to see the cases check the box next to the desired site If there is a site you don t want to see and it is checked uncheck it to deselect it More than one site can be viewed at the same time VPIMS GasChart Selection Screen File Edit View Scheduling dt dt dt tr r te r r ve te dt r s Search By Date 9 T
126. ystem Medication Events Mic all Chipped or loose tooth Esophageal intubation Laryngospasm Reintubation unplanned Soft tissue trauma Category Reason You can also add comments in the bottom white comments box at the bottom of the screen If there is a text field where notes can be entered you will see a d icon If you click on this icon you will be directed to the quick comments page If you have saved quick comments you can use those to fill in the text box Or you can just type in the text box without clicking the d icon Business Rule Either the No Events Occurred box must be checked or there must be an event documented 119 Delays Add Delay The delays section is used to report intraoperative delays This information does not appear in ACR it is used to identify system inertia This field is required if case is started after the scheduled time Click on the Delays tab to enter information Click on one of the items in the Delay Category to display a list of the available Delays D Delays oB Selected Delays Comments gf 120 Then double click on the Delay you would like to add It will appear in the bottom box of Delays Checklist Earlier Case Ran Over Selected Delays Category Reason Intraop ln Room Earlier Case Ran Over Comments ot 121 Delete Delay To delete an event double click it Then click Yes to confirm J Delays of SCIP EMR

Gas Chart - Vanderbilt University Medical Center

Contents

Download Pdf Manuals

Related Search

Related Contents