S Oosterhaven | PubMed Health

PubMed1988

[Experiences with an anesthesia protocol written by computer].

Since December 1983, we have used a computer system for charting and data logging in cardiac and thoracic anesthesia. These computers, designed as stand-alone units, were developed at our hospital based on Motorola 6809 microprocessor systems. All measurements derived from anesthetic monitoring, ventilator, and heart-lung machine are automatically sampled at regular intervals and stored for later data management. Laboratory results are automatically received from the hospital computer system. The user communicates with the system via a terminal and a keyboard; this also facilitates the entering of all comments, medications, infusions, and fluid losses. All data are continuously displayed on an A3 format anesthetic chart using a multi-pen, flat-bed plotter. The operation of the system has proved to be simple and needs less time than charting by hand, while the result, the display on the chart, is far clearer and more complete than any handwritten document. Up to now 3,200 operations (corresponding to 12,500 anesthetic h) have been documented. The failure rate of the system, defined as an interruption of the documentation for more than 30 min is 2.1%. Further development of the system is discussed. A data base for processing the stored data has been developed and is being tested at present.

Anesthesia, General↗

PubMed1987

Carola, a computer system for automatic documentation in anesthesia.

A computer system has been designed for documentation and data acquisition during open heart surgery. This computer system (called 'Carola') processes all patient data during cardiac surgery. More than 50 analogue or digital signals are scanned. These are derived from a monitoring rack, a Siemens Servo 900B ventilator with its accessory devices and a heart lung machine. All these values are plotted as well as offline data, such as medications, fluids, laboratory results and user comments, on an A3 format anesthetic record using an eight pen flat bed plotter. Simultaneously all data is written onto a cassette tape. These tapes are then transferred to a database for storage and statistical processing. The sampling frequency is every 10 seconds, averages being calculated over one minute periods. The chart is updated once a minute normally or every 15 minutes for slowly changing signals e.g. temperatures. Hardware and software of the computer have modular design. The hardware consists of two Motorola 6809 based microprocessor systems. The software is entirely written in Pascal. The user interface is implemented on a menu driven basis. A terminal with a keyboard is used for the communication with the users, namely anesthetic nurses and anesthesiologists. The system was readily accepted by the users. The menu structure proved to be easy to learn and allowed fast entries, even when the users were not previously accustomed to the use of a keyboard. The clear and detailed presentation of the data on the plotted chart helped to detect trends early and facilitated therapeutic decisions. From december 1983 the first prototype was used on a routine basis, followed by a second unit in June 1984 and a third in December 1985. Up to now more than 12.500 anesthetic hours have been recorded. Since then almost 100% of all anesthetics performed in our cardiothoracic unit have been documented by the computers, including all short procedures without invasive monitoring and all emergencies.

Anesthesiology↗