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

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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 -
D
  • Name:
  • Age:
  • Gender:
  • Phone:
  • and Address:


Select the Save & Continue button at the bottom of the page. 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.
On Fibrinolytic Checklist page, 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 at the bottom of the page. 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

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.