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.
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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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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View the PK/PD graphs of all drugs modeled for the current
case.
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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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Use this window to select PK models, graph display options,
and default drug concentrations.
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View the
Disclaimer, User Guide, and PK/PD Model references.
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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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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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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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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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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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The PK/PD Graph window displays pharmacokinetic and
pharmaco-dynamic graphs for all drugs modeled in the current
case.
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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:
The following options can be set in the "Settings" screen:
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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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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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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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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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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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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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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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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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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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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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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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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