STEMI-2017/C2/EMRI-or-Ambulance-data-entry/English

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Topic: EMRI or Ambulance data entry
Contributor Name: Jerry David, STEMI Team, Coimbatore
Reviewed by: Nancy Varkey, Spoken Tutorial Project, IIT Bombay

Keywords: STEMI, STEMI App, Data entry in STEMI App, Data entry of mandatory fields in Main ECG tab


VISUAL CUE NARRATION
Show TITLE slide

EMRI or Ambulance data Entry

Hello and welcome to this tutorial on EMRI or Ambulance data entry.
Show Learning Objectives Slide In this tutorial, we will learn to enter data of a new patient on the STEMI App from an ambulance.
Show System Requirement Slide To practise this tutorial, you will need -
  1. An Android tablet with STEMI App installed on it and
  2. A working Internet connection.
Switch to STEMI device interface We are in the STEMI Homepage.
Select New Patient Select New Patient tab.
Let’s assume a patient and enter the following data.
Type the following details

Patient Name: Ramesh

Age:53

Gender: Male

Phone : 9988776655

Address: X villa, X road, Coimbatore – 000 000, Tamil Nadu

Under Basic Details, let us enter-
  • Patient Name: Ramesh
  • Age:53
  • Gender: Male
  • Phone : 9988776655
  • Address: X villa, X road, Coimbatore, Tamil Nadu
Select the Save & Continue button at the bottom of the page. Select the Save & Continue button at the bottom of the page.
Pop-up message Immediately, the page gets saved.

And “Saved Successfully” pop-up message appears at the bottom of the page.

On Fibrinolytic Checklist page The App now takes us to the next page, Fibrinolytic Checklist.
On Fibrinolytic Checklist page Under Fibrinolytic Checklist, there are 12 items, if the patient is Male.

If the patient is Female, there would be 13 items displayed.

The extra item is Pregnant Female ? Yes / No, which we have to fill accordingly.

Check the following
  1. Systolic BP Greater than 180 mmHg - No
  2. Diastolic BP Greater than 110 mmHg - No
  3. Right Vs Left arm Systolic BP greater than 15 mmHg – No
  4. Significant closed head/facial trauma within the previous 3 months – No
  5. Recent (within 6 weeks) major trauma, surgery (including laser eye surgery),GI/GU Bleed – No
  6. Bleeding or clotting problem or on blood thinners – No
  7. CPR greater than 10 min -No
  8. Serious systemic disease (e.g., advanced/terminal cancer, severe liver or kidney disease) –No
  9. History of structural central nervous system disease -No
  10. Pulmonary edema (rales greater than halfway up - No
  11. Systemic hypoperfusion (cool, clammy) - No
  12. Does the patient have severe heart failure or cardiogenic shock such that PCI is preferable such that PCI is preferable? - No
I’ll will be checking all the 12 points as “No” for now.
  1. Systolic BP Greater than 180 mmHg - No
  2. Diastolic BP Greater than 110 mmHg - No
  3. Right Vs Left arm Systolic BP greater than 15 mmHg – No
  4. Significant closed head/facial trauma within the previous 3 months - No
  5. Recent (within 6 weeks) major trauma, surgery (including laser eye surgery), GI / GU Bleed – No
  6. Bleeding or clotting problem or on blood thinners –No
  7. CPR greater than 10 min - No
  8. Serious systemic disease (e.g., advanced/terminal cancer, severe liver or kidney disease) –No
  9. History of structural central nervous system disease - No
  10. Pulmonary edema (rales greater than halfway up - No
  11. Systemic hypoperfusion (cool, clammy) – No
  12. Does the patient have severe heart failure or cardiogenic shock such that PCI is preferable? - No
Show Slide

The options are-

  • To a D hospital
    • if it is the closest and the Hub hospital is beyond 30 minutes of travelling distance and if Thrombolysis is not contraindicated


OR

  • To a A/B Hospital (Hub)
    • if it is within 30 minutes of travelling distance and if Thrombolysis is contraindicated.
The Fibrinolytic Checklist is a relative or absolute contraindication for thrombolysis.

It helps the paramedic in the ambulance determine whether to shift the patient.

  • To a D hospital
    • if it is the closest and the Hub hospital is beyond 30 minutes of travelling distance
    • and if Thrombolysis is not contraindicated

OR

  • To a A/B Hospital (that is Hub)
    • if it is within 30 minutes of travelling distance
    • and if Thrombolysis is contraindicated.
Select the Save & Continue button at the bottom of the page. Once the Fibrinolytic Checklist is completed, select the Save & Continue button at the bottom.
Buffering sign is seen. This will save the current page.

Please wait if buffering sign is seen.

Pop -up message Saved Successfully” pop - up message appears at the bottom of the page
On Co morbid Conditions page And we are moved to the next page – Co-Morbid Conditions.
Co - Morbid Conditions page Under Co-Morbid Conditions, we will find the details of History and Co-Morbid Conditions.
Check the following

Under Co – Morbid Conditions >> History and Co - Morbid Conditions


Smoker: Yes

Previous IHD: Yes

Diabetes Mellitus: Yes

Hypertension: Yes

Dyslipidemia: Yes

Stroke: Yes

Bronchial Asthma: Yes

Allergies: Yes

I’ll check all as ‘Yes’




Smoker: Yes

Previous IHD: Yes

Diabetes Mellitus: Yes

Hypertension: Yes

Dyslipidemia: Yes

Stroke: Yes

Bronchial Asthma: Yes

Allergies: Yes

Diagnosis

Chest Discomfort: options Pain, Pressure, Aches;

Aches selected

Diagnosis

Chest Discomfort: options are Pain, Pressure, Aches

I’ll select Aches

Location of Pain: options Retrosternal, Jaw, L arm, R arm, Back; L arm selected

Location of Pain: options are Retrosternal, Jaw, L arm (i.e. left arm), R arm (i.e. right arm), Back

I’ll select L arm

Pain Severity ( a mandatory field) – type from 1 -10 : 8

Pain Severity (a mandatory field): on a scale of 1 - 10, 1 being least and 10 being extreme pain,

I’ll choose 8

Palpitation: Yes

Pallor: Yes

Diaphoresis: Yes

Shortness of breath: Yes

Nausea/ Vomiting: Yes

Dizziness: Yes

Syncope: Yes

Palpitation: Yes

Pallor: Yes

Diaphoresis: Yes

Shortness of breath: Yes

Nausea/Vomiting: Yes

Dizziness: Yes

Syncope: Yes

Select the Save & Continue button at the bottom of the page. Once the data is entered, select the Save & Continue button at the bottom of the page.
Buffering sign is seen. This will save the current page.


Please wait if buffering sign is seen.

Pop - up message Saved Successfully” pop-up message appears at the bottom of the page.
On Transportation Details page And we are moved to the next page – Transportation Details.
Under Transportation Details- >> Symptom Onset

Date: 21/1/2016 Time: 9:00 am

Under Transportation Details, all the 5 fields are mandatory.

Symptom Onset

Date: and Time:

Ambulance Call

Date: 21/1/2016 Time: 9:10 am

Ambulance Call

Date: and Time:

Ambulance Arrival

Date: 21/1/2016 Time: 9:30 am

Ambulance Arrival

Date: and Time:

Ambulance Departure

Date: 21/1/2016 Time: 9:45 am

Ambulance Departure

Date: and Time:

Transport to STEMI Cluster

Yes: No:

Transport to STEMI Cluster

Yes No

if Yes is selected it further opens into
  • Google maps -
  • Contacts -
If Yes is selected, it further opens into
  • Google maps - to locate and select the hospital on the Google Maps for directions
  • Contacts - to call or get contact details of the hospital to which the patient is being shifted
Medications during Transportation

Oxygen: if Yes

Oxygen Amount: 5L/ 10L

select 5L

Medications during Transportation:

Oxygen: if Yes, Oxygen Amount: 5L/ 10L

I’ll select 5L

Aspirin 325mg : if Yes

Date: 21/1/2016 Time: 9:50 am

Aspirin 325mg : if Yes

Date: and Time:

Clopidogrel 600 mg: if Yes

Date: 21/1/2016 Time: 9:52 am

Clopidogrel 600 mg :if Yes

Date: and Time:

Prasugrel 60 mg: if Yes

Date: 21/1/2016 Time: 9:54 am

Prasugrel 60 mg: if Yes

Date: and Time:

Ticagrelor 180 mg: if Yes

Date: 21/1/2016 Time: 9:56 am

Ticagrelor 180 mg: if Yes

Date: and Time:

Unfractionated Heparin: if Yes,

Route: IV

Dosage:bolus 60U/kg

Date: 21/1/2016 Time:9:58 am

Unfractionated Heparin: if Yes

Route: IV

Dosage: bolus 60Units/kg

Date: andTime:

LMW Heparin


N Saline: 2 pint

Nitroglycerine: 5mcg /min

Morphine: 1mg /ml

Atropine: 1ml amp

Similarly, for LMW Heparin. I’ll select as ‘No’ for now.


  • N Saline: 2 pint
  • Nitroglycerine: 5mcg /min
  • Morphine: 1mg /ml
  • Atropine: 1ml amp
Select the Save & Continue button at the bottom of the page. Once data is entered,
  • select the Save & Continue button at the bottom of the page,
  • to save the page and move on to the next.
Go back to Transport to STEMI Cluster field

Select No

If ‘No’ is selected under Transportation to STEMI cluster then
  • Save and Continue button appears below the field
  • and data entry for the particular page ends here.
Select Save and Continue Select Save and Continue button.
Buffering sign is seen. This will save the current page.


Please wait if buffering sign is seen.

Pop - up message Saved Successfully” pop-up message appears at the bottom of the page
On Discharge Summary page And we are moved to the next page – Discharge Summary.
Under Discharge Summary

If checked “Yes”, it further opens into

Cause of death: choose between Cardiac / Non Cardiac; >> choose Cardiac

Death

Date: and Time: 10:10 am Remarks: if any

Under Discharge Summary, Death is a mandatory field.

If checked “Yes”, it further opens into -

  • Cause of death: choose between Cardiac / Non Cardiac;
    • I’ll choose Cardiac
  • Death
    Date: and Time:
  • Remarks: if any

And the data entry ends here.

Under Discharge Summary

If checked “No” it further opens into Discharge from EMRI

Date: 21/1/2016 Time: 10:10 am

If Death is checked “No”, it further opens into Discharge from EMRI


Date: and Time:

Transport To:

Select from Stemi Cluster Hospital, Non Stemi Cluster Hospital, Home


Select Stemi Cluster Hospital

Transport To:

Select from Stemi Cluster Hospital, Non-Stemi Cluster Hospital or Home.


I’ll select Stemi Cluster Hospital.

If “STEMI Cluster Hospital or Non STEMI Cluster Hospital” >>

Remarks: blank

Transfer to Hospital Name: Kovai Medical Center and Hospital


Transfer to Hospital Address: 3209, Sitra, Avinashi Road, Coimbatore, Tamil Nadu - 641 014


Highlight in blue box

Hospital name and address have to be entered manually for Non STEMI cluster Hospital

If “STEMI Cluster Hospital or Non STEMI Cluster Hospital” is selected, it further opens into-
  • Remarks: if any
  • Transfer to Hospital Name: Kovai Medical Center and Hospital
  • Transfer to Hospital Address: 3209, Avinashi Road, Sitra, Coimbatore, Tamil Nadu - 641 014

When we select the hospital name, the hospital address auto-populates.

This is because this hospital is a part of the STEMI programme.

Select the Finish button at the bottom of the page. After this data is entered, select the Finish Tab at the bottom of the page.
Buffering sign is seen. This will save the current page.

Please wait if buffering sign is seen.

On STEMI Homepage Now the page is saved and data entry is completed.
Pop - up message Saved Successfully” pop-up message appears at the bottom of the page.
Let us summarize.
Show Summary Slide In this tutorial, we have learnt to enter data of a new patient on the STEMI App from an ambulance.
Show STEMI INDIA slide STEMI INDIA
  • was set up as a ‘not for profit’ organisation
  • primarily to reduce delays in accessing appropriate care for heart attack patients
  • and reducing deaths due to heart attacks.
Show Spoken Tutorial Project Slide Spoken Tutorial Project, IIT Bombay is funded by NMEICT, MHRD, Govt. of India.

For more details, please visit http://spoken-tutorial.org

Show THANK YOU slide This tutorial has been contributed by
  • STEMI INDIA
  • and the Spoken Tutorial Project, IIT Bombay.

This is Nancy Varkey signing off. Thanks for joining.

Contributors and Content Editors

Nancyvarkey, PoojaMoolya