STEMI-2017/C3/EMRI-to-D-to-AB-Hospital/English

Topic: EMRI Ambulance to D Hospital to AB Hospital

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 ambulance to D Hospital and A/B Hospital	Hello and welcome to this tutorial on transfer from EMRI ambulance to D Hospital and A/B Hospital.
Show Learning Objectives Slide	In this tutorial, we will learn to - Enter data of a new patient on the STEMI App from an EMRI ambulance. Enter further data for the same patient on the STEMI App in a D Hospital and later in an A/B Hospital
Switch to STEMI device interface	We are in the STEMI Homepage.
Blue box on stemiEuser	Notice here. It says stemiEuser. That means the EMRI ambulance paramedic is making these entries.
Select New Patient	Select New Patient tab.
	Let’s assume a patient and enter the following data.
Type the following details Patient Name: Venugopal Age:48 Gender: Male Phone : 9988776655 Address: X villa, X road, Coimbatore – 000 000, Tamil Nadu	Under Basic Details, let us enter the patient's - Name: Age: Gender: Phone: and Address:
Select the Save & Continue button	Select the Save & Continue button at the bottom of the page.
On Fibrinolytic Checklist page	The App now takes us to the next page, that is Fibrinolytic Checklist.
Put text on screen.	Under Fibrinolytic Checklist, there are 12 items if the patient is Male. There would be 13 items displayed, if the patient was Female. The extra item is Pregnant Female? Yes / No Which we have to fill according to the gender of the patient.
Check all of the following as NO	I will be checking all the 12 points as “No” for now.
Select the Save & Continue button.	Then select the Save & Continue button to save the current page.
On Co-Morbid Conditions page	We are moved to the next page – Co-Morbid Conditions.
	Here we have History And Co-Morbid Conditions.
	I’ll mark some of these as Yes.
Diagnosis	Then comes the Diagnosis section.
Chest Discomfort >>Pain selected Location of Pain >> Retrosternal selected Pain Severity >> 8 selected	Chest Discomfort: I’ll select Pain Location of Pain: I’ll select Retrosternal Pain Severity: I’ll choose 8
Palpitation: Yes Diaphoresis: Yes Shortness of breath: Yes Nausea/ Vomiting: Yes Dizziness: Yes	After this, I'll select YES for some of the remaining items.
Select the Save & Continue button	Then select the Save & Continue button to save the current page.
On Co morbid Conditions page	We are in the next page – Transportation Details.
Under Transportation Details- Symptom Onset Date: 21/1/2016 Time: 9:00 am Ambulance Call Date: 21/1/2016 Time: 9:10 am Ambulance Arrival Date: 21/1/2016 Time: 9:30 am Ambulance Departure Date: 21/1/2016 Time: 9:45 am	Under Transportation Details, all the fields are mandatory. So, I'll make the entries for - Symptom Onset Date: and Time: Ambulance Call Date: and Time: Ambulance Arrival Date: and Time: Ambulance Departure Date: and Time:
Transport to STEMI Cluster Yes: No: If Yes is selected Blue box on Google maps Blue box on Contacts Blue box on Medications during Transport Oxygen: if Yes Oxygen Amount: 5L/ 10L >> select 5L Aspirin 325mg : if Yes Date: 21/1/2016 Time: 9:50 am Clopidogrel 600 mg: if Yes Date: 21/1/2016 Time: 9:52 am Prasugrel 60 mg: if Yes Date: 21/1/2016 Time: 9:54 am Ticagrelor 180 mg: if Yes Date: 21/1/2016 Time: 9:56 am Unfractionated Heparin: if Yes Route: IV Dosage:bolus 60U/kg Date: 21/1/2016 Time:9:58 am LMW Heparin N Saline: 2 pint Nitroglycerine: 5mcg /min Morphine: 1mg /ml Atropine: 1ml amp	Next is Transport to STEMI Cluster Yes/No. 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 Then under Medications during Transportation:, we have to enter the relevant details, as shown here.
Select the Finish button	Lastly, select the Finish button at the bottom of the page.
Go back to Transport to STEMI Cluster field Select No	If ‘No’ is selected under Transport 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.
	This will save the current page.
On Discharge Summary page	And we are moved to the next page – Discharge Summary.
Under Discharge Summary -I’ll check Death as “No”	Under Discharge Summary, Death is a mandatory field. I’ll check this as “No” for now.
Date: 21/1/2016 Time: 10:10 am Transport To: Select from Stemi Cluster Hospital	Next we have to enter Discharge from EMRI Date: and Time: In Transport To: I’ll select Stemi Cluster Hospital.
Remarks: if any Transfer to Hospital Name: Kovai Medical Center and Hospital Transfer to Hospital Address: 3209,Sitra, Avinashi Road Coimbatore, Tamil Nadu - 641 014	It further opens into- Remarks: if any Transfer to Hospital Name: Transfer to Hospital Address: When we select the hospital name, the hospital address gets auto-populated. This is because this hospital is already part of the STEMI programme. If this hospital was not part of the STEMI programme, then we would have to manually enter - the hospital name and hospital address.
Select the Finish button	After this data is entered, select the Finish button at the bottom of the page.
	This will save the current page.
	Now the data entry for a new patient from the EMRI Ambulance is completed.
Slide	The patient has now arrived at a D Hospital.
Slide	This is the synopsis of the procedure to be followed at the D Hospital.
Blue box on stemiAuser	We are in the STEMI Homepage as a D Hospital user.
Select Search tab	Select the Search tab.
Type Venugopal >> select Search	Type the Id or name of the patient and select the Search button at the bottom of the page.
	Select the particular patient from the displayed list.
Blue box on Basic Details	We are now moved to the page – Basic Details. To edit the particular page, select the Edit button at the top right corner of the page.
	Here, all the details filled in the EMRI Ambulance are displayed.
Blue box on A/B Hospital Arrival Date and Time.	In the D Hospital, we will have to fill the D Hospital Arrival Date and Time.
Blue box on Manual ECG Taken Yes/No. Select Yes.	After that, is Manual ECG Taken Yes/No. I'll select this as Yes.
Blue box on ECG Date and Time	Then fill the Date and Time of the ECG.
Blue box on STEMI Confirmed Yes/No. Select Yes.	Next is STEMI Confirmed Yes/No. I'll select Yes here.
Blue box on STEMI Confirmed Date and Time.	And then fill the Date and Time.
Select Save and Continue	Select the Save and Continue button at the bottom.
Blue box on Fibrinolytic Checklist	We will skip the Fibrinolytic Checklist page and move to theCardiac History page.
	First, we will enter the relevant details related to the patient's history.
Blue box on Clinical Examination	Then under Clinical Examination, enter the details for that particular patient.
Select Save and Continue	Select the Save and Continue button at the bottom.
Blue box on Co-Morbid Conditions	We are moved to the Co-Morbid Conditions page.
	Here we are prompted to enter the medicines that the patient is on, as per his medical condition. Pls make the relevant entries for that patient.
Select Save and Continue	Then select the Save and Continue button at the bottom.
Blue box on Contact Details	We are moved to the Contact Details page.
Blue box on Name, Relation Type, Address, City and Mobile no.	Here, we have to enter the Name, Relation Type, Address, City and Mobile no. of the patient's relative.
Blue box on Occupation	Then enter the Occupation.
Blue box on Aadhar Card No.	After, this comes the Aadhar Card No.
Blue box on Upload Aadhar card.	On doing so, we will prompted to upload a copy of the Aadhar card.
Select Save and Continue	Select the Save and Continue button at the bottom.
	Next we will skip the Transportation Medications page. This page has the details of medication administered to the patient while transfer to D hospital.
Blue box on Medications prior to Thrombolysis	We will now move on to the Medications prior to Thrombolysis page.
	Select the Edit button at the top right corner of the page to edit the particular page.
	Here, enter the details of the medications administered to the patient prior to Thrombolysis.
Blue box on Asprin	I'll enter Asprin as Yes, then enter the Dosage, Date and Time.
Blue box on Clopidogrel Blue Text box: Please note that selection of medication and doses are meant for demo purposes only. Administer drugs as per patient condition and treatment modalities.	Then I'll enter Clopidogrel as Yes, and enter the Dosage, Date and Time.
Select Save and Continue	Select the Save and Continue button at the bottom.
Blue box on Thrombolysis	We are moved to the Thrombolysis page.
Blue box on Select any one Thrombolytic agent Select Streptokinase.	Here, select any one Thrombolytic agent. I'll select Streptokinase.
Blue box on Dosage, Date and Time.	Then enter the Dosage, Date and Time.
Blue box on 90 min ECG, Date and Time.	90 min ECG, Date and Time.
Blue box on Successful Lysis Yes/No.	Successful Lysis Yes/No.
Select Save and Continue	Select the Save and Continue button at the bottom.
	We will skip the In-Hospital Summary page.
Blue box on Discharge Summary >> Death highlight edit button	We are now in the next page that is Discharge Summary. Select the Edit button at the top right corner of the page to edit the particular page. Here we have the tab Death.
Select No.	I’ll select the option No.
Select Save and Continue	Then select the Save and Continue button at the bottom.
Blue box on Discharge Medications.	Next comes Discharge Medications.
	Once again, select those medications advised to the patient at the time of discharge
Select Save and Continue	Select the Save and Continue button at the bottom.
Blue box on Discharge/Transfer	Now we are in the Discharge or Transfer page.
Select Add Transfer Details	Select Add Transfer Details button.
Blue box on Discharge from the A/B Hospital	Here we need to enter the details related to the discharge from the D Hospital.
	I‘ll select STEMI Cluster Hospital.
	It further opens into Remarks, if any.
	Transfer to Hospital Name.
	When we select the hospital name, the hospital address gets autopopulated. This is because this hospital is already part of the STEMI programme.
	In Transport Vehicle field, choose GVK EMRI Ambulance.
	Next comes Ambulance Call Date and Time.
	Ambulance Arrival Date and Time.
	Ambulance Departure Date and Time.
Select Finish	Now select the Finish button.
Slide	The patient is once again transferred via EMRI ambulance to an A/B Hospital.
Slide	The patient has now arrived at an A/B Hospital.
Slide	This is the synopsis of the procedure to be followed at the A/B Hospital.
	Let's now learn how to enter further data on the STEMI App in the A/B Hospital.
Blue box on stemiAuser	We are in the STEMI Homepage as an A/B Hospital user.
Select Search tab	Select the Search tab.
Type Venugopal >> select Search	Type the Id or name of the patient and select the Search button at the bottom of the page.
	Select the particular patient from the displayed list.
Blue box on Basic Details	We are now moved to the next page – Basic Details.
	Once the patient file is opened select the Edit button at the top right corner to open the Edit Mode. Do likewise to edit the remaining pages.
	Here, all the details filled in the EMRI Ambulance and the D Hospital are displayed.
Blue box on A/B Hospital Arrival Date and Time.	In the A/B Hospital, we will have to fill the A/B Hospital Arrival Date and Time.
Select Save and Continue	Select the Save and Continue button at the bottom.
Blue box on Fibrinolytic Checklist	We can skip the following pages- Fibrinolytic Checklist page Cardiac History page Co-Morbid Conditions page Contact Details page Medications prior to Thrombolysis page and Thrombolysis page
Blue box on PCI	We have moved directly to the PCI page.
Blue box on Drugs before PCI	Here we have Drugs before PCI tab.
Make entries in PCI No narration - Blue text box Please note the selection of medications and doses are meant for demo purposes only . Administer drugs as per patient condition and treatment modalities.	Enter the details of the drugs administered to the patient before PCI, with Date and Time details.
Select Save and Continue	Select the Save and Continue button at the bottom.
On PCI page	The next page is PCI.
Remove blue box around Cath Lab Activation and Cath Lab Arrival	Details under PCI are to be filled either by a Cardiologist or a Cath Lab Technician. First we will enter Cath Lab details such as Cath Lab Activation and Cath Lab Arrival
Blue box on Vascular access Blue box on Catheter access.	Next is Vascular access followed by Catheter access.
Blue box on CART, Start & End Date and Time	Then fill the CART details such as Start Date and Time End Date and Time
Blue box on Culprit Vessel	After this, we have to specify any one Culprit Vessel from the options provided.
	Then enter all the details relevant to that Culprit Vessel.
Blue box on Management	Now, make the entries under Management for that patient.
Blue box on Intervention	Lastly on this page, we have Intervention.
Select Intervention	When the option Intervention is selected, we get some more details below.
	Fill out the ones that are relevant for that particular patient.
Select Save and Continue	Select the Save and Continue button at the bottom.
Blue box on Medications in Cath Lab	We are now in the Medications in Cath Lab tab.
	Here I will fill in the details related to 2b3a Inhibitors.
	I'll check Unfractionated Heparin as Yes.
	Then enter the Dosage, Date and Time.
No narration - Blue text box Please note that selection of medications and the doses are meant for demo purposes.. Administer drugs as per patient condition and treatment modalities.
Select Save and Continue	Select the Save and Continue button at the bottom.
	Once again, we can skip the pages related to In-Hospital Summary.
Blue box on Discharge Summary >> Death	We are in the next page that is Discharge Summary. Select the Edit button at the top right corner of the page to edit the particular page. Here we have the tab Death.
I’ll Select No.	Select the option No.
Select Save and Continue	Then select the Save and Continue button at the bottom.
Blue box on Discharge Medications.	Next comes Discharge Medications.
	Select those medications advised to the patient at the time of discharge.
Select Save and Continue	Select the Save and Continue button at the bottom.
Blue box on Discharge/Transfer	Now we are in the Discharge or Transfer page.
Blue box on Discharge from the A/B Hospital	Here we need to enter the details related to the discharge from the A/B Hospital.
Select Home	I’ll select Home.
Point to Remarks	Next we have to enter Remarks, if any.
Transport Vehicle>> select Private vehicle.	In Transport Vehicle field, I’ll select Private vehicle.
Select Finish	Lastly, select the Finish button.
	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 EMRI ambulance. Enter further data for the same patient on the STEMI App first in a D Hospital and then in an A/B Hospital.
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