Configuration method for an anesthesia protocol system

Vital parameters of patient and medication parameters are automatically combined to form anesthetic protocols. A multi-step configuration method facilitates anesthesia protocol system reconfiguration. All the groups which may be taken into account for a possible future reproduction of the anesthesia protocol are first defined by combining parameters to form a group. A configuration name is assigned to each group. In a subsequent step, each anesthesia protocol segment has one of the groups assigned to it. The steps of forming the groups and assigning the groups to segments are repeated for each configuration. In a subsequent on-line mode of the anesthesia protocol system, the operator reconfigures the system by using the configuration name.

FIELD OF THE INVENTION 
The present invention refers to an anethesia protocol system configuration 
method for the screen display of an anesthesia protocol and/or for the 
form of a printout of an anesthesia protocol, said screen display as well 
as said form of printout being determinable by an operator. When such a 
method is carried out, a plurality of parameters comprising vital 
parameters of the patient and/or a medication parameter and/or a parameter 
for an adjustment of gas and/or a machine parameter are generally combined 
in a manner which can be defined by the operator for obtaining the screen 
display and/or the printout of the anesthesia protocol. 
DESCRIPTION OF THE PRIOR ART 
In all hospitals it has been common practice for decades that anesthesia 
protocols are manually recorded by the anesthetist in the course of each 
anesthesia carried out. 
A typical anesthesia protocol includes two areas above the time axis, viz. 
an upper area indicative of the variation with time of the medication, 
i.e. the administration of medicaments e.g. in absolute amounts or, in the 
case of anesthetics, also in percentages of the respiratory gas, and a 
lower area of the anesthesia protocol within which the socalled vital 
parameters are recorded. 
The typical content of an anesthesia protocol comprises the following 
information: the operating area, i.e. the area of the patient's body which 
has been operated on; the manner in which the patient was positioned 
during the operation, e.g. laid on his back, laid on his stomach, etc.; 
the technical means used for the anesthesia, viz. gas monitors as well as 
measuring instruments for the electrocardiogram, for CO.sub.2, for 
SO.sub.2, for the invasive or the non-invasive blood pressure, for the 
central venous pressure, etc.; the type of artificial respiration or 
ventilation, viz. the spontaneous respiration (the patient breathes 
himself), the assisted, viz. machine-assisted respiration, such as IPPV 
(intermittent positive pressure ventilation), PEEP (the kind of artificial 
respiration which holds the pressure on a specific level during 
expiration), etc.. 
In this lower area of the anesthesia protocol, socalled trend curves, viz. 
e.g. the trend curves of the systolic and of the diastolic blood pressure 
as well as the trend curve indicating the cardiac rate, are shown by 
points above the time axis. When the recording is carried out in the form 
of point curves, symbols for the various trend curves are typically used, 
said symbols comprising e.g. triangles, dots and the like. 
Some doctors prefer a tabular reproduction of numerical values instead of 
such reproductions in the form of curves. 
Furthermore, in the anesthesia protocols made by hand, socalled events or 
medically relevant occurrences are recorded in the form of numerical marks 
at the trend curves, and explanations assigned to these numerical marks 
are added below the protocol. 
If, for example, a sudden rise in the patient's blood pressure occurs, a 
specific number will be recorded by the side of the blood pressure trend 
curve at the time the rise in blood pressure occurs, and the medical 
reasons for this rise in blood pressure are indicated in connection with 
said number at some other point of the protocol. 
Furthermore, for statistical purposes as well as for statements of account, 
the presence of the anesthetist, the length of the actual time of 
anesthesia, intubation and extubation are recorded in the anesthesia 
protocol above the time axis, said data being supplemented by the 
patient's data and data on persons from the medical sphere who were 
present. 
It is obvious that the manual production of an anesthesia protocol is a 
substantial additional burden for the anesthetist and that especially 
during a critical condition of the patient, the precise recording of which 
would be particularly important in connection with an anesthesia protocol, 
the anesthetist will normally not find time for updating the anesthesia 
protocol. Hence, especially in situations which are critical from the 
medical point of view, the anesthetist will be compelled to make the 
anesthesia protocol from memory after having the patient protected from 
acute danger, and this will naturally result in an inaccurate or 
incomplete anesthesia protocol. 
Since these problems have been recognized, automatic anesthesia protocol 
systems or narcosis protocol systems have already been created, which are 
connected to patient monitors and to an anesthesia machine via interface 
connections and which automatically procure the patient's vital parameters 
from the interfaces in the manner explained hereinbelow, store these 
parameters and combine them so as to obtain an anesthesia protocol in the 
manner which will be described hereinafter. 
FIG. 1 is a schematic representation of such a known anesthesia protocol 
system, which has supplied thereto input signals representing at least the 
socalled vital parameters derived from the patient and supplied to patient 
monitors MD1, . . . , MDn, the output signals of said monitors being 
supplied to an interface IF1, IF2. The type of interface is not of 
decisive importance--neither for the purpose of the present assessment of 
the prior art nor for the purpose of the present invention. Interfaces 
which may be used are normal serial interfaces, such as the standard 
interface RS232, or also special data networks for data of patients, which 
are offered by the applicant under the name of HP Care-Net-Interface. 
The digital curve signals thus produced are stored in a data base by a data 
processing unit (which is not shown), said data base being organized like 
a ring buffer having a specific ring buffer length in such a way that, 
after storage of a number of curve signal values corresponding to the ring 
buffer length, the respective oldest curve signal value is overwritten by 
the respective youngest curve signal value. In other words, the data base 
DB1 has provided therein a plurality of tracks used for storing all the 
curves and having each a predetermined length, said tracks being 
repeatedly overwritten with a determinable size like a ring buffer. The 
data base DB1 has provided therein one "track" for each curve of interest. 
In the known system, a monitor MO is provided, which can be controlled by 
the data processing unit for displaying the real time curves or trend 
curves. 
Furthermore, the known system is capable of automatically producing 
anesthesia protocols and outputting them either on the monitor or on a 
printer. 
For this purpose, the known system derives from the curves socalled trend 
curves within the patient monitors. These trend curves are normally values 
which are derived from the curves and which have a markedly lower time 
resolution. A trend curve for the systolic and the diastolic blood 
pressure can, for example, be derived from the curve representing the 
blood pressure behaviour. Such trend curves are stored in a second data 
base e.g. with a time resolution of one trend curve signal value per 
second. The thus obtained point values for the trend curves are then 
reproduced as a screen display or as a printout of a printer. The curves 
thus obtained constitute an essential component of the automatically 
produced anesthesia protocol whose outward appearance largely corresponds 
to the anesthesia protocol made by hand as far as the representation of 
the trend curves is concerned. 
In the known anesthesia protocol system according to FIG. 1, a screen 
display or a printout of an anesthesia protocol to be created is produced 
on the basis of all parameters, which consist of the values stored in the 
data base DB1 or of the trend curves derived from said values, by 
selecting one configuration from a predetermined group of configurations. 
These configurations have been defined in advance in a socalled "off-line" 
mode in such a way that each segment or field of the anesthesia protocol 
to be displayed on the screen or to be printed out has assigned thereto a 
specific parameter. Such a predetermined configuration can, for example, 
comprise a representation of specific vital parameters and machine 
parameters of the anesthesia machine in tabular form or in the form of 
symbols. A different configuration may comprise specific groups of 
medication parameters in predetermined fields or segments of the 
anesthesia protocol to be produced, said medication parameters being, for 
example, the time of administration of medicaments and the time of supply 
of specific respiratory gases or anesthetic gases. In any case, the 
configuration of the known anesthesia protocol system for defining a 
specific screen display or a specific form of printout of the anesthesia 
protocol is carried out in a single-step mode by directly assigning 
parameters to the segments of the anesthesia protocol. 
In view of the fact that a typical anesthesia protocol comprises a large 
number of parameters, a modification of the configuration of the known 
anesthesia protocol system for creating a new display or a new form of 
printout of an anesthesia protocol entails extensive and troublesome work. 
SUMMARY OF THE INVENTION 
It is the object of the present invention to provide an anesthesia protocol 
system configuration method for the screen display of an anesthesia 
protocol which can be defined by an operator and/or for the form of a 
printout of an anesthesia protocol which can be defined by an operator, 
said configuration method simplifying the reconfiguration of the system. 
This object is achieved by an anesthesia protocol system configuration 
method for the screen display of an anesthesia protocol and/or for the 
form of a printout of an anesthesia protocol, said screen display as well 
as said form of printout being determinable by an operator, wherein a 
plurality of parameters comprising a vital parameter of the patient and/or 
a medication parameter and/or a parameter for an adjustment of gas and/or 
a parameter of an anesthesia machine are combined in a manner which can be 
defined by the operator for obtaining the screen display and/or the 
printout of the anesthesia protocol, said method comprising the following 
steps: 
a) defining a configuration name for each desired configuration; 
b) defining all the groups which may be taken into account for a possible 
future reproduction in a segment of the screen display and/or of the 
printout of the anesthesia protocol by combining the parameters belonging 
to the respective group and by assigning a configuration name to this 
definition; 
c) defining a screen display and/or a printout of the anesthesia protocol 
by assigning a respective one of said groups to each segment of the screen 
display and/or of the printout of the anesthesia protocol; 
d) repeating steps b) and c) for each configuration taken into account and 
assigning each time a configuration name to each configuration; and 
e) selecting the desired screen display and/or the desired printout of the 
anesthesia protocol through the operator by means of the configuration 
name. 
The configuration method according to the present invention uses for the 
first time a three-step structure for defining the configuration. 
By means of a first method step, which should expediently be carried out in 
an "off-line" mode of the system, all the groups which may be taken into 
account for a possible future reproduction in a segment of the screen 
display and/or of the printout of the anesthesia protocol are defined by 
combining the parameters belonging to the respective groups. Prior to this 
step or during this step, a configuration name is assigned to this 
definition. 
In a second step, a screen display and/or a printout of the anesthesia 
protocol is defined by assigning a respective one of said groups to each 
segment of the screen display and/or of the printout of the anesthesia 
protocol. 
The above-mentioned steps are repeated for each configuration taken into 
account and a separate configuration name is assiged to each 
configuration. 
In a third step of the method according to the present invention, the 
operator selects the desired screen display and/or the desired form of 
printout of the anesthesia protocol by means of the configuration name, 
said third step being carried out in an "on-line" mode, i.e. during the 
production of the anesthesia protocol. 
The three-step structuring of the configuration of the anesthesia protocol 
system according to the present invention permits a simple, fast and 
flexible production of various anesthesia protocols satisfying the 
personal demands or ideas of the anesthetist who works with the system in 
question. 
In a preferred embodiment of the invention, the steps a), b) and c) are 
carried out in a so-called off-line mode outside a program for generating 
and displaying on a screen and/or printing out the anesthesia protocol. 
In another preferred embodiment of the method in accordance with the 
invention, the step d) is carried out in a socalled on-line mode during 
the program used for generating and displaying on a screen and/or printing 
out the anesthesia protocol. 
In another preferred embodiment of the method in accordance with the 
invention, prior to step a), a parameter pool is formed in such a way 
that, among the vital parameters supplied by patient monitors (MD1, . . . 
, MDn), those parameters are eliminated which are redundant or which 
correspond to one another so that the parameter pool will include each 
vital parameter only once; 
wherein, prior to step a), a medication pool is additionally formed on the 
basis of medication parameters indicating the nature and the amount of the 
gases and/or anesthetics and/or medicaments and/or infusions and/or 
transfusions supplied to the patient; and 
wherein step b), in which the groups are defined, combines the vital 
parameters and/or the medication parameters so as to form groups. 
Further developments of the configuration method according to the present 
invention are defined in the subclaims.

DESCRIPTION OF THE PREFERRED EMBODIMENTS OF THE INVENTION 
A plurality of vital parameters, which are detected by means of patient 
monitors MD1, . . . , MDn FIG. 2a, are supplied via system interfaces IF 
of the type used in the prior art and illustrated in FIG. 1 to the 
anesthesia protocol system in a manner which is known per se, said 
anesthesia protocol system combining these vital parameters in a first 
data base DB1 FIGS. 2a, 2b and 2c, in the form of a so-called parameter 
pool. In this first step, parameters of interest, which may, for example, 
be the cardiac rate, the systolic or diastolic blood pressure, etc., are 
selected. A selection is necesssary, since various medical devices, which 
form the patient monitors MD1, . . . , MDn, supply partly identical or 
redundant parameters among which only the parameters which are relevant 
with regard to future anesthesia protocol formation are chosen. 
After this selection, the list of parameters produced in the first data 
base DB1 includes each parameter only once, i.e. the cardiac rate, for 
example, is included only once notwithstanding the fact that various 
patient monitors each supply information on the cardiac rate 
independently. The parameter pool thus formed is device-independent and 
includes each parameter only once. 
Parallel to said parameter pool, a medication pool is formed whose 
parameters comprise information on the amount of respiratory gas, the kind 
of anesthetic gas and the amount of anesthetic gas, kinds and amounts of 
infusions and transfusions and the like. This medication pool is filed in 
a second data base DB2 in FIGS. 2a, 2b, and 2c, which may correspond to 
the first data base DB1 with regard to its structure. 
The sequence of method steps following hereinafter is carried out once for 
each configuration. Taking as a basis the parameters contained in the 
parameter pool and in the medication pool, all the groups which may 
possibly be reproduced later on in a segment of a screen display or of a 
printout of the anesthesia protocol to be produced are defined in the next 
step by combining the respective parameters belonging to one group. When 
this step is being started, a configuration name is assigned. When a 
plurality of parameters is combined in this way so as to form one group in 
each case, a pool of groups assigned to the configuration in question will 
be obtained. The pool of groups represents those combinations of 
parameters variable above the time axis which are to be displayable in 
combination, said parameters being, for example, medicaments, infusions, 
transfusions and vital parameters. 
Each anesthesia protocol to be produced includes plural segments. In the 
example shown, each anesthesia protocol comprises three segments. 
In the second main step of the configuration method according to the 
present invention, a plurality of possible screen displays D1 and D2, FIG. 
2b, and/or forms of printout of the anesthesia protocol is defined by 
assigning to each segment of each screen display and/or form of printout 
of the anesthesia protocol one of the groups of said pool of groups. Also 
this assigning is carried out in an off-line mode, i.e. prior to the 
actual use of the anesthesia protocol system for producing the anesthetic 
protocols. The two-step method which has been described up to now is 
carried out once for each configuration which may possibly be reproduced, 
and whenever said two-step method is carried out different configuration 
names are assigned to the various configurations. 
After this off-line configuration of the system, a configuration of the 
system can be effected by the operator in a third method step within the 
on-line mode, i.e. during the actual production of the anesthesia protocol 
by the anesthesia protocol system, by selecting the desired screen display 
D1, D2 and/or the desired printout of the anesthesia protocol by means of 
the configuration name. 
On the basis of the above description, it will be obvious to the person 
skilled in the art that anesthetic protocol systems of the type described 
may detect a number of data wich is substantially larger than the number 
of data which can be displayed on a single display for an anesthesia 
protocol. The measures of assigning first specific parameters to specific 
groups and, subsequently, specific groups to segments of a display in an 
off-line mode permits a simple off-line preconfiguration of the system, 
and this off-line preconfiguration can be extended by additional 
configurations with little effort. It is, for example, possible to select 
from a pool of groups a fully configurated display segment with a 
preselected group of parameters so that parameters of this type belonging 
together for medical reasons can be made a segment of the anesthesia 
protocol by means of a single selecting operation. 
One example of a group formation carried out during the generation of the 
pool of groups is, for example, the combination of the anesthesia machine 
parameters or the combination of specific vital parameters of the patient. 
The off-line pregrouping performed by creating the pool of groups will 
make it easier for the user to create new types of anesthetic protocols by 
compiling suitable groups. 
The configuration name, which has already been assigned upon starting the 
step in which the pool of groups is created, may, for example, be the name 
of the anesthetist in charge or the designation of the anesthesia to be 
carried out or of the medical procedure to be performed. 
This means that each of the screen displays D1, D2 which will be selectable 
in the on-line mode later on has assigned thereto a configuration name by 
means of which the appropriate screen display can be called. 
Deviating from the method described, it is also possible to take as a basis 
the groups which have been formed by producing the pool of groups and to 
carry out an on-line compilation of the screen display by making use of 
the predefined groups. Also when this alternative is used, it is possible 
to incorporate, by direct selection, a missing parameter into the screen 
display D1, D2 or into the printout during the on-line mode, i.e. the mode 
of operation in which the anesthesia protocol is produced by means of the 
screen or the printer, for modifying thus a previous group definition in 
such a way that a missing parameter can additionally be included. Such a 
modification of the predefined group preferably has only a temporary 
effect and influences solely the current screen display.