AnestAssist User Guide

User Guide

1.0 Introduction

Welcome to the AnestAssist™1.1 User Guide. Click/tap a section of the outline above or scroll through the guide to access individual sections. 

2.0 Toolbar

Use the toolbar at the bottom of the screen to navigate to each of the main windows of the program. Touch each button to switch between windows.
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2.1 Patient Info Button

This window allows you to enter, edit, and review all relevant information about the currently modeled patient. From this view you can also add a new case, or select a filed case from the Case Library
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2.2 View PK/PD Button

View the PK/PD graphs of all drugs modeled for the current case.
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2.3 Drug Input Button

View and add to a list of drugs given for the current case. Press the Add button at the top right to add a new drug given entry to the list. Press Delete to delete a drug given entry from the list. PK/PD results are recalculated and updated when drugs are added or deleted.
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2.4 Settings

Use this window to select PK models, graph display options, and default drug concentrations.
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2.5 Help

View the Disclaimer, User Guide, and PK/PD Model references.
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3.0 Patient (Case) Info Window Details

This window is used to add a new case and edit an existing case.

Touch the white spaces beside Case Name, Case Description, and Case ID to enter this information. These fields are for your reference only and you can use any way you like. The Case Name and Description are displayed in the Case Library list and used to identify the case.

Touch the white spaces beside Age, Height, and Weight to enter this information, and select Gender by touching Male or Female from the toggle buttons next to the Gender field. These parameters are used by the PK/PD models to adjust calculations of concentration and effect estimates.
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3.1 Case Library

The Case Library is accessed via the Case Library button at the top of the Patient Info window. The Case Library is a collection of cases which you have entered into AnestAssist. A "case" consists of all the information entered into the "Patient Info" screen and all of the drugs given (including times, concentrations, and amounts). When you create a new case it is automatically filed in the Case Library along with patient informations and drugs given for that case. At any time later you can access the list of cases in the library and select one for review and/or editing.
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3.2 Adding a New Case

To add a new case, from the Patient Info window click on the New Case button, or from the Case Library window press the Add New button.. Input the Case Start Time and click the Save and Start button.
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3.3 Selecting a Filed Case

To select a filed case, touch the Case Library button in the top left corner of the Patient Info window. Scroll to the desired case and touch it to access its information in the Patient Info screen. The case selected becomes the "current case" in AnestAssist and you can view and edit/update it as such.
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3.4 Deleting a Filed Case

To delete a filed case, click on the Case Library button in the top left corner of the Patient Info window. Once in the Case Library screen, touch the "Delete" button in the top left corner. Simply touch on the case you wish to delete and touch the delete button.
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4.0 PK/PD Graph Window Details

The PK/PD Graph window displays pharmacokinetic and pharmaco-dynamic graphs for all drugs modeled in the current case.
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4.1 Operation

When more than one drug has been entered for a case, the Switch Drug button at the top of the screen can be used to toggle the display to view each drug entered for the case.

To enter a drug administered to the patient, pressing the Enter Drug button at the top of the screen takes you directly to the Drug Given entry screen(s).

To view all or part of the case, the graphs can be panned (scrolled) and zoomed using standard iPhone touch gestures. That is, the same touch gestures used to pan and zoom a photo in the Photos app will also work with the PK/PD graphs. Specifically:

  • Panning (scrolling): With one finger touching the screen, move finger left or right to move the traces in that direction.
  • Zooming: With two fingers touching the screen, move fingers together ("pinch") to zoom out, and move fingers apart to zoom in.

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4.2 Time and Concentration Axes

The following options can be set in the "Settings" screen:

  • The time axis may be set to display either elapsed time or clock time.
  • The concentration axis scale may be set to either fixed scale or auto scale.

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4.3 Duration of Modeled Results

The models are set to calculate begining at the start of the case and ending at 2 hours after the time of the last drug given.
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5.0 Drug Input Window Details

The Drug Input window displays a list of drugs given to the patient during the case, and allows you to add and delete drug given entries from this list.
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5.1 Adding a New Drug Given

To add a new drug given to the patient, press the Add button at the the top right of the Drug Input screen. New screens appear where you enter the drug name/concentration, time given, and amount given (see below). Tap each item's field to enter a values for them. After all items are entered press 'Save' at the top of the screen. The PK/PD models are updated to relect this addition. You will be returned to the Drug Input list where you will see the new entry.
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5.1a Name of Drug Given

Select either the IV Drug List or the Inhaled Agent List button. Use the 'thumb-wheel" wheel control to select the drug given. AnestAssist fills in a default concentration for the drug. If that concentration is not correct then tap the concentration field and enter the correct concentration, and also select the correct units from the control below the concentration field (note you can enter a default concentration for remifentanil from the "Settings" window). Press Save at the top of screen when complete.
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5.1b Time Given

Use the 'thumb-wheel" wheel control to select the time the drug was given. AnestAssist fills in a default time, which is either the current clock time, or 1 hour from the time of the last drug given time. Notice that AnestAssist displays time as both "wall clock" and "case time" (elapsed time since begining of case). There are buttons to advance or backup the selected time in 5 and 10 minute increments to speed entry. Press Save at the top of screen when complete.
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5.1c Amount Given

Select either Bolus or Infusion as method of administration. Units appropriate to the selected method appear in the Units control bar. Select the units you wish to use and enter the actual amount in the Amount field. Press Save at the top of screen when complete.
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5.2 Deleting a Drug Given

To delete a drug given press the Delete button at the top of the screen and then tap the drug entry you wish to delete. The PK/PD models are updated to reflect this deletion.
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6.0 Settings Window Details

The Settings window contains user selectable options. Changes may be made at any time and are immediately applied to the current case. Settings are saved in a global state file which is loaded every time AnestAssist starts.
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6.1 Graph Time Axis

The time axis of the PK/PD graphs may be set to either Clock time or Elapsed time. Clock time is the actual time of day, and elapsed time is the time since the start of case.
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6.2 Graph Concentration Scale

The vertical axis (concentration) of the PK graphs can be set to auto-scale or fixed-scale. Fixed scale values are set to internal values which will accomodate most cases. Auto scale values adjust to the maximum value of the case data being reviewed.
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6.3 Propofol Model

The propofol model used can be set to either the model of Schnider et al or the model of Marsh et al.
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6.4 Default Remifentail Concentration

The default remifentanil concentration administered can be specified here. This is the concentration which is shown and settable in the Drug Given Amount window when adding a drug given.
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