A4 Format Research Articles

RECALL—an integrated system for making, retrieving and analysing anaesthetic records

Summary This chapter describes a computerized system that has been designed to increase the accuracy, accessibility and utility of anaesthesia records. The software has been designed to provide flexible and easy data entry by anaesthetists. The extensive use of personalized menus allows rapid entry of intraoperative comments and noting of drug administrations. A chronological summary is instantly available whenever required. Drug data include time, dose, elapsed time since the previous dose and cumulative dose. All comments are automatically time and date stamped, and where appropriate, entries are checked to ensure that they lie within a legitimate range. To provide maximum flexibility, hand-held computers can be used for data collection on the ward as well as in the theatre. The system features direct interfacing of patient monitors which allows sampling at much faster rates than is possible using manual methods. A unique modular interface provides the flexibility to use a wide range of monitors of different makes and types. There is a full-colour, real-time trend graph of vital signs in a familiar format, and other screens may be selected without interrupting the acquisition of data in real time. Printed anaesthetic records are available both during and after the operation. The standard file copy for general use is in A4 format and contains all important data presented in chronological order. It is possible to obtain more detailed output for specialized needs. All data are stored in an electronic database from which records can be retrieved within seconds whenever required. Internal coding makes use of the Read Clinical Classification enabling meaningful exchange of data with other systems. Individual work stations are intended to be linked in a local area network which allows access to the shared database from any work station. There is also the potential for direct communication with the hospital patient administration system (PAS). The system produces a number of routine reports relevant to departmental activity analysis and analysis of resource usage. The database is interfaced to statistics software which gives access to a wide range of powerful techniques in addition to providing presentation-quality tables and graphs. In summary, the RECALL system is designed to automate the task of anaesthetic record-keeping so far as this is practicable and to free the anaesthetist's time for patient-oriented activities. It incorporates many features of practical importance and has proved a useful contribution towards improved standards of patient care. It makes it easy to prepare and retrieve anaesthetic records and its capability to analyse recorded data offers valuable aid in medical audit and theatre administration.

Book reviews

The main authors of this A4 format book are two experienced radiographers working in collaboration with several consultant dental surgeons, a representative of Siemens Ltd, and the College of Radiographers. The slim volume is a collection of articles previously published in Radiography, together with a supplement, and is intended to provide general radiographers with not only an insight into dentistry, so that the value of various radiographic techniques becomes apparent, but also a resumé of the shortcomings of some of these techniques. The first chapter is divided into two to deal initially with a history of the development of dental panoramic tomography, the principles and practice of the technique and radiation doses. There are also illustrations of normal radiographic anatomy and the results of faulty patient positioning. The second half outlines the shortcomings of the panoramic technique with particular reference to width of focal trough, production of secondary shadows, image overlap and superimposition.

Organising a practice. Problem identification, disease management, and audit.

In general practice records much important information is buried among trivia even with an A4 format. Many hospital letters from follow-up clinics give little more information than the original letter does. We decided to weed and summarise the notes. All FP8 and 9 cards containing irrelevant information and all but one of the hospital letters for each episode of illness were extracted and torn up. The main items were summarised and written on a Royal College of General Practitioners (RCGP) pink summary card. The card was filed on top of the current A4 note sheet, where it can be seen first each time the notes are opened. This task was approached with trepidation on account of the amount of work it required. Elliott1 was only able to summarise 120 notes in one year. Our notes are summarised in odd moments before and after surgeries, and always by partners. The average time taken for a summary is four and a half minutes, and the average number done a day is three and a half. Certain disease entities need to be easily identified at each patient contact. We decided to mark the outside of the folders for these disease groups, and used the RCGP system with the following changes : (i) black and white squares indicate neoplasia ; (ii) a light green tag indicates bronchospasm; (iii) a puce tag indicates arteriosclerosis that limits a patient's life or needs treatment.

Thin film cdS 0.6Se 0.4:Cu photoresistor linear array for document analysis

Charge-coupled devices (CCD) can be used for facsimile document analysis. An alternative possibility is the use of an electronically scanned linear array of photoresistors. A 1728-element array is suitable for the analysis of an ISO A4-format document with a resolution comparable to that given by the most perfect mechanical procedures, yet at a much faster rate. This paper describes a new method for the deposition of a photoconductive thin film, obtained by coevaporation and annealing of CdS 0.6Se 0.4:Cu. It also describes a new technique for fabricating the array, so that the semiconductor film is protected during the various processing steps. The 72 mm-long prototypes, with 8 photodetectors per mm, can be easily juxtaposed in order to increase the length of the linear array and allow the analysis of an A4 (or larger) format.

Making a National Atlas of Population by Computer

This paper describes the conceptual and practical problems encountered and solved in producing a multi-colour atlas of population characteristics in Great Britain. The atlas itself is in A4 format; it consists of some thirty-four maps of Great Britain in four colours and the same number of regional maps, together with descriptive text. All maps were plotted on a laser plotter with a resolution of 127 microns.The paper describes how mapping of ratios, such as percentages, was found to be highly misleading and describes the novel probability mapping solution adopted, based on the signed chi-square statistic. In addition, the rationale for selecting the class intervals and for selecting colour schemes is described.