HI everyone. We are trying to create a template to help intensive care prescribe ventilator settings.We search CKM and Apperta and we didn´t find any. Is there any archetype already build to use?
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@johngrant4est started a thread about an initiative which may have included this a while ago. Maybe there’s something come out of that?
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Thanks for the tip.
Hi,
my colleague at Hannover Medical School did some integration work based on ventilation data. The main issue is that this is hugely complex and the naming of the parameters sometimes depends on the vendor (Siemens, Dräger…). Though, I might be able to get some information what parameters he was able to extract and if this was put into archetype elements. If this is of interest, I will try to get some info
Hi,
I built some ages ago that I shared with @johngrant4est yesterday.
It would be very helpful, if only to underpin reporting.
Here are my efforts.
openEHR-EHR-ACTION.mechanical_ventilation.v1.adl (3.3 KB)
openEHR-EHR-CLUSTER.ventilator_settings.v1.adl (28.0 KB)
openEHR-EHR-CLUSTER.ventilator_settings2.v1.adl (31.8 KB)
Be kind - don’t laugh . The background was really Nursing ICU Observations for Ljubljana Paediatric Hospl.
Laughter is fine, coughing on the other hand…
I’m watching with interest a couple of initiatives that are being driven by the CV pandemic, the most exciting one of which is :
https://twitter.com/willtube4food/status/1242126762282278918
I’ve also been using the free time to review a couple of really good documents on modelling the modes and mechanics of ventilators, authored by a Canadian anesthesiologist called Steve Dain and assisted by Norman Jones whose background is engineering.
As you can see, these, are quite technical, but we have to start somewhere. Hoping to write a bit of narrative on how to model this kind of thing in OpenEHR in next few days.
Saying that, I got “the letter” from the NHS today inviting me out of semi-retirement so there may be other pressures on my time quite soon…
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Stepping back a little from the complexities of modelling, in order of importance, I’d list the following variables as “mandatory” in describing assisted ventilation:
- Tidal Volume (Vt)
- Airway Pressure (Paw)
- Rate (breaths/min)
- I:E ratio
The first three are self-explanatory. The fourth requires a little more explanation.
Rather than elaborate, there is a good description here:
https://derangedphysiology.com/main/cicm-primary-exam/required-reading/respiratory-system/Chapter%20539/inspiratory-pause-ie-ratio-and
The data generated by a modern ventilator is much greater in scope and complexity.
Some variables are measured directly, others are derived. In an emergency, if you just record Vt, rate and Paw, that would be sufficient.
that’s a great pdf - I will have a crack and post it here for others to fill out an improve on.
Based on the PDF above openEHR-EHR-CLUSTER.ventilation_modes.v0 (2).adl (12.8 KB)
Discuss…
The am in question is whether to model each mode quantity and other values explicitly or just leave it to the application to determine the correct units for e.g.
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Silly question, but what’s the best environment for opening *.adl - the Marand archetype designer ?
Yup - Go into Archetype Designer and into a repository (or create a new one) and import the adl - you can drag and drop from a Chrome download link (from history or at the bottom of the screen).
Sorry about the delay in responding, but things are becoming complicated here in Porto. Thank you all for the input.