Fig. 8.  (A ) Avionics from a modern aircraft. This is a picture of an avionic screen from a Boeing aircraft that integrates information to provide the pilot with visual alerts, allowing for simultaneous management of the aircraft's integrity, lift, yaw, pitch, air speed, and navigation. Photograph from Integrated Electronic Standby Instrument from Thales Aerospace Division Web site (available at: http://www.thalesgroup.com/aerospace; accessed November 10, 2010). Reprinted with permission from Thales Avionics, Saint-Laurent, Quebec, Canada. (B ) The visual alert system (RiskWatch) is a prototype “avionics” display for anesthesia. It integrates live data from the physiologic monitors, the anesthesia information management system (AIMS), the history and physical (H&P), and the laboratory in a color-coded graphic display. Green indicates normal range; yellow, marginal range; red, abnormal range; and orange, “at risk.” The system shows the heart beating with the heart rate and the lungs inflating and deflating with the respiratory rate. The level (filling volume) within the heart is calculated using continuous I and O calculation based on the patient's weight and nothing by mouth (NPO) time, estimated blood loss (EBL), and fluid resuscitation. Data regarding adequate filling volume are automatically retrieved from systolic pressure variation, central venous pressure (CVP), or pulmonary diastolic if those data are available. (Left ) Characteristics of the case. (Middle ) The moving diagram with each organ system. (Below ) The pertinent laboratories. If any system has risk factors that are derived from the patient's H&P, they are orange. The box on the right is where alerts are displayed. It automatically alerts when any variable is out of a safe range and for presumptive diagnoses of tension pneumothorax and potential malignant hyperthermia. The patient has risk factors for a difficult airway and heart disease (this patient has a pacer). There is a high filling volume (CVP = 24 mmHg) and high potassium concentration. Reprinted with permission (Kevin K. Tremper, University of Michigan, Ann Arbor).

Fig. 8.  (A ) Avionics from a modern aircraft. This is a picture of an avionic screen from a Boeing aircraft that integrates information to provide the pilot with visual alerts, allowing for simultaneous management of the aircraft's integrity, lift, yaw, pitch, air speed, and navigation. Photograph from Integrated Electronic Standby Instrument from Thales Aerospace Division Web site (available at: http://www.thalesgroup.com/aerospace; accessed November 10, 2010). Reprinted with permission from Thales Avionics, Saint-Laurent, Quebec, Canada. (B ) The visual alert system (RiskWatch) is a prototype “avionics” display for anesthesia. It integrates live data from the physiologic monitors, the anesthesia information management system (AIMS), the history and physical (H&P), and the laboratory in a color-coded graphic display. Green indicates normal range; yellow, marginal range; red, abnormal range; and orange, “at risk.” The system shows the heart beating with the heart rate and the lungs inflating and deflating with the respiratory rate. The level (filling volume) within the heart is calculated using continuous I and O calculation based on the patient's weight and nothing by mouth (NPO) time, estimated blood loss (EBL), and fluid resuscitation. Data regarding adequate filling volume are automatically retrieved from systolic pressure variation, central venous pressure (CVP), or pulmonary diastolic if those data are available. (Left ) Characteristics of the case. (Middle ) The moving diagram with each organ system. (Below ) The pertinent laboratories. If any system has risk factors that are derived from the patient's H&P, they are orange. The box on the right is where alerts are displayed. It automatically alerts when any variable is out of a safe range and for presumptive diagnoses of tension pneumothorax and potential malignant hyperthermia. The patient has risk factors for a difficult airway and heart disease (this patient has a pacer). There is a high filling volume (CVP = 24 mmHg) and high potassium concentration. Reprinted with permission (Kevin K. Tremper, University of Michigan, Ann Arbor).

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