Journal of clinical monitoring
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The typical, handwritten anesthesia record of the 1980s does not satisfy its many users. The document is used for clinical care by the anesthetist, nurses, physicians, and technicians in postanesthesia, intensive, and postoperative surgical care units; for historical information by the billing officer, the statistician, and the anesthetist in preparation for a future anesthetic; and for the review of the quality of care by clinical peers and lawyers. ⋯ Electronic capture, storage, retrieval, and formatting of data can generate electronic displays or paper records tailored to answer the needs of specific users. The anesthetist in particular will benefit from a well-designed system that takes the place of the traditional handwritten anesthesia record.
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Pulse oximeter arterial hemoglobin oxygen saturation (SpO2) and finger arterial pressure (FINAP) were continuously monitored before, during, and after cardiopulmonary bypass in 15 male patients. SpO2 was monitored simultaneously with two pulse oximeters, a Nellcor N-100 and an Ohmeda Biox III. The readings obtained from the two pulse oximeters were compared with arterial blood measurements obtained using a CO-oximeter. ⋯ The mean bias +/- precision of FINAP-IAP for mean pressure was 8.3 +/- 10.2 mm Hg (SD) and the correlation coefficient was 0.814. During cardiopulmonary bypass, the Finapres device functioned well in 10 of 15 patients. The mean bias precision of FINAP-IAP, for mean pressure in these 10 patients was 6.6 +/- 8.7 mm Hg and the correlation coefficient was 0.902.(ABSTRACT TRUNCATED AT 250 WORDS)
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Written records and first-generation hospital information systems do not meet their primary purpose to assist physicians in solving patients' problems. Simply automating the present chart formats is not the answer. An example of the concept needed for charting is the intensive care unit chart. ⋯ Automation of the anesthesia record should free the anesthesiologist of the need to search for preoperative information and to manually record most information intraoperatively. Decisions about how much data to archive and how to extract the data pertinent to continuing care are the challenges for physicians. The technologic tools are available for the design and implementation of a software system that focuses on effective communication of the patient's problems throughout the perioperative period as the patient moves from ward to operating room, through the recovery room and intensive care unit, and to the ward and home.