Manage Anesthetics

The anesthetics used in surgery display in the Anesthetics/Vitals tab once you have selected a case and appointment.

Tip: If the tab does not display, right-click the appointment and select Enable Anesthetics/Vitals tab.

You can click the Toggle Text/Graphic View () and ( ) icons to view anesthetics in text or graphic mode.

Note: If vitals and anesthetics are set to the same view (both text or both graphic), they are time-synched.

This view displays the list of surgery drugs, the units (measuring systems, percentages, weights, or volumes), the methods of drug delivery to the patient, the total units of anesthesia administered from start to present, and the units of anesthesia considered unused or wasted (if applicable).

Note: Drug types that require entered waste display with a pink background.

It also displays the values for those drugs as numbers and percentages in horizontal rows, measuring time incrementally from left to right. Values in black text indicate that the entries are in a normal range, values in orange text indicate that the dosage value or total dosage is approaching a maximum, and values in red text indicate that the maximum dosage value or total dosage has been reached.

This view displays the surgery drugs list and plots the values for those drugs, as entered, from left to right.

It also displays each surgery stage with a different colored background.

A blue dot (●) indicates that a drug entry value has been entered and is in a normal range, while an orange circle (Ο) indicates that the dosage entry value or total dosage is nearing the maximum level, and a red circle (Ο) indicates that the maximum dosage value or total dosage has been reached. A line between dots indicates continuous values (usually displays for gases inhaled or liquids with continuous flow).

To manage anesthetics:

  1. Select a patient and open the EHR module > Case Management tab.
  2. Select a case and an appointment and click the Anesthetics/Vitals tab.
  3. Review the listed entries.

  4. To perform another task, complete any of the following:

    5. Depending on your institution's setup, common anesthetics may be added by default to your surgery drugs list. When necessary, you can adjust the surgery drugs before or during surgery.

    1. Click the Surgery Drugs () icon to display the Surgery Drugs window.

    2. Review the listed entries.

    3. Complete any of the following tasks as necessary:

      1. Click the Clear Data () icon.
      2. Select the drug from the Anesthetic Drug drop-down list.
      3. Select the Unit, Delivery, and Gauge values from the corresponding drop-down lists.
      4. Click the Add a new Record () icon.
      1. Select a listed entry.
      2. Make any necessary changes and click the Modify Record () icon.
      1. Select a listed entry and click the Delete Record () icon.
      2. When prompted, click Yes to confirm the deletion.

    4. Close the Surgery Drugs window.

      5. The updated drug list displays in the Anesthetics/Vitals tab.

    As drugs are administered to the patient, data is entered manually into axiUm. Columns (representing times) are added throughout the surgery at specified intervals (usually 5 minutes). Data can be entered into these columns, or if a drug is administered outside of one of these times, a manual entry (and column) can be added.

    Certain surgery drugs follow specific entry guidelines:

    • If the unit is a percentage, the values range from 0 to 100.
    • If the unit is not a percentage, values display to two decimal places (e.g., 3.25 or 3.00).
    • If a drug is administered continuously:
      • The dosage value for a new time column defaults to the value in the previous column, as axiUm assumes the previous value is continued until otherwise specified.
      • You must enter a value of 0 when the drug dose ends.
    • If a drug is a percentage mixture (e.g., nitrous oxide, mixing nitrous and oxygen), these display on multiple rows, one per drug. When one value is entered (e.g., nitrous is 60%), the percentage of the other drug is calculated automatically (e.g., oxygen is 40%), to make 100%.

    To enter anesthetic values:

    1. Select the cell that represents the drug and time of administration and enter the dosage value(s).

      2. Note: If the time is not displayed in a column, click NEW to display the column and specify the time of the entry, then press Enter to create the column.

      Tip: Use keyboard shortcuts. You can press Ctrl + N to open a new column or press Ctrl + T to edit an entered time. 

      Note: If the drug is a percentage mixture of another drug, entering the value for one of the drugs auto-calculates the other drug's value.

    2. To perform another task, complete any of the following:

      3. In some cases, it is necessary to clear column data from the Anesthetics/Vitals tab.

      Note: Removed column data still displays in the Anesthetic History window.

      To clear a column:

      1. Right-click a cell and select Clear Column (Anesthetics).

        2. The anesthetics column clears.

      In some cases, it is necessary to remove a column from the Anesthetics/Vitals tab.

      Note: Removed column data still displays in the Anesthetic History window.

      To a delete column:

      1. Right-click a cell and select Delete Column.

        2. The entire column is removed from the tab.

        Important: This clears the associated vitals column as well.

    Waste is the quantity of an anesthetic drug remaining at the surgery’s end or wasted during the surgery.

    The quantity appears in the Waste column on the right side of the anesthetics pane.

    Note: If required, the column cell displays in pink until a value has been entered.

    To enter the anesthetic waste:

    1. In the Waste column, select the cell across from the correct drug.
    2. Enter the waste value and click the next cell or press Enter.

      3. The cell color turns white.

      Note: The entry auto-saves when you click away from the cell.

      Tip: If you remove the waste entry, the background color reverts to pink.

    When data is entered for a drug that requires waste approval, axiUm displays a teal Approve Waste indicator and an Approve button beside the indicator becomes active.

    Waste approvals must be completed:

    • After the operative stage is over and the all anesthetic data, including the waste values, has been entered.
    • Before surgery approval can be completed.

    Note: Once the waste is approved, users who require approval can no longer enter waste values. Users who can approve waste can modify waste values after approval to make corrections.

    To approve waste:

    1. Click Approve to display the User Authentication window.
    2. The anesthetic approver enters or swipes their credentials.

      3. The waste is approved, and the indicator beside the Approve button changes to one of the following: 

      • Approve Surgery: This displays if the surgery entries (vitals and anesthetics) require approval.

      • Approved: This displays if surgery approval is not required.

    axiUm records all anesthetic data entered during a surgery with full audit information. This includes any deleted anesthetic and vitals columns.

    You can view the history of any drug used in the surgery, including the time it was added or updated, along with the associated unit and value.

    To view anesthetic history:

    1. In the anesthetics section, click the Show History () icon to display the Anesthetics History window.

    2. (Optional) From the Show drop-down list, select Anesthetic entries or Waste.
    3. (Optional) Next to the Filter by field, select the Surgery Time or Drug radio button to narrow history criteria.
    4. Select a listed entry to display information in the Values section and review as necessary.