Arcos Burn Navigator RX User Manual

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Burn Navigator

User's Manual

June 2019

For Burn Navigator RX

Manual-1143

Version V.6.1h

Revision G

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Page 1 ® Burn Navigator User’s Manual June 2019 For Burn Navigator RX Manual-1143 Version V.6.1h Revision G...
Page 2: Table Of Contents
Contents Description ....................4 Intended Use ................... 4 Safety Information ................... 4 Use Warnings ..................4 Incoming Device Setup, Cleaning & Maintenance, Handling ....6 Tablet Description ..................8 First-time Operation ................9 Using the Burn Navigator ................ 11 Main Menu ................... 11 Training Mode ..................
Page 3 Trademarks ..................... 57 Index .......................58 Notes .......................59 Burn Navigator® User’s Manual Page 3...
Page 4: Description
Description Burn Navigator® is a Clinical Decision Support tool to help health care providers manage IV fluid therapy for adult and pediatric severe burn patients. Each Burn Navigator device allows resuscitation of only one patient at a time. Intended Use The Burn Navigator is indicated for use in the care of adult patients with 20% or more Total Body Surface Area (TBSA) burned, or pediatric patients, 24 months old or older, weighing at least 10 kg with 15% or more TBSA burned, as a fluid resuscitation monitor and calculator...
Page 5 WARNING! The Burn Navigator uses Urine Output as a surrogate for general organ perfusion. If Urine Output is not or no longer a good surrogate for organ perfusion in a particular patient, such as can happen with acute renal failure or use of diuretics, consult with attending physician for appropriate fluid therapy.
Page 6: Incoming Device Setup, Cleaning & Maintenance, Handling
Incoming Device Setup, Cleaning & Maintenance, Handling Incoming device setup • Make sure the system date, time and time zone are correct. Turn on Burn Navigator, press the System button, then press the Change Date/Time button. • Check battery status and recharge the batteries if they are not full. The battery indicator in the top right of the screen shows four bars when full.
Page 7 Operational environment Place the computer on a flat stable surface. Do not place the computer upright or turn it over. If the computer is exposed to an extremely strong impact, it may become damaged. Temperature: Operation: –10 °C to 50 °C {14 °F to 122 °F} (IEC60068-2-1, 2) * Storage: –20 °C to 60 °C {–4 °F to 140 °F} Humidity: Operation: 30% to 80% RH (No condensation)
Page 8: Tablet Description
Tablet Description The Burn Navigator RX device uses a Getac RX10h tablet computer. Getac RX Model Front Components 1 : Front Camera 2 : Fingerprint Scanner 3 : Microphone 4 : Light Sensor 5 : Power Status LED • Off: Power off/Hibernation •...
Page 9: First-Time Operation
First-time Operation AC Adapter (1) AC Power Cord (1) Battery Pack (2) CMP-1621 CMP-1622 CMP-1623 Digitizer Pen and Tether (1) USB Data Drive (1) CMP-1632 CMP-1640 Inserting the Battery Pack 1 Hold the battery pack with the Getac serial number label facing the device. 2 Ensure that the keyed black connector is facing to the right (east).
Page 10 Using the digitizer pen You can use Burn Navigator RX by touching screen in the same way as the mouse. Touch the screen surface with the digitizer pen (included). Attaching the digitizer pen to the computer • Pass one end of the tether (loop 1 in...
Page 11: Using The Burn Navigator
Using the Burn Navigator CAUTION Before using the Burn Navigator, assess the patient and perform any lifesaving interventions needed. The Burn Navigator is a fluid calculator and does not provide direct therapy to the patient. Touchscreen The Burn Navigator has a touchscreen. The touchscreen is a resistive-type screen, so it will work even if you are wearing gloves, but you may have to apply more pressure to the Burn Navigator screen than with other touchscreens you have used before.
Page 12: New Patient Setup
New Patient Setup From the Main Menu, press “Start New Patient” or “Training Mode”. 1. Press the first white text field to enter the Patient ID. 2. You will then see a touch keyboard appear on the screen. a. The “arrow” key is Caps Lock. b.
Page 13 5. Choose the protocol. a. Adult predictive algorithm: Targets 30-50 mL/hr Urine Output (UO). This protocol uses the Salinas algorithm developed by the US Army Burn Center (Salinas, J et al, Computerized decision support system improves fluid resuscitation following severe burns: An original study, Crit Care Med 2011, 39(9), 2031-8).
Page 14 7. Patient height is an optional field for the Adult predictive protocol. Note: Body surface area is calculated using the Haycock algorithm. 8. Enter elapsed time since burn occurred. How long ago did the burn happen? Note: There are two separate number fields: one for hours and one for minutes.
Page 15 10. On the Recommendation screen, you may choose the primary resuscitation fluid type. Lactated Ringer’s is selected by default. a. Options include albumin protocols, where the primary fluid to be titrated is composed of, e.g., 2/3 LR and 1/3 Albumin 5%. If you choose one of these protocols, you will see the calculated rate for each fluid under the “Recommended rate”...
Page 16: Checklist
Checklist After you start a new patient, a pop-up message will ask you to complete a patient assessment checklist. Press “Yes”. On the checklist screen you can enter vitals and labs, as well as completing extremities steps and observations. The Checklist allows you to track other indicators of resuscitation status other than urine output.
Page 17: Hourly Fluid Updates
Hourly Fluid Updates The Fluid Update Wizard (series of screens) will appear automatically when it is time to do an hourly fluid update. The Urine Data screen shows the “From” and “To” times for this update. a. The “From:” time is the last time you entered data (new patient setup or last hourly update).
Page 18 the time period, unless you update the pump setting changes timely on the Home screen or provide the total volume during the fluid update. • If a bolus of the primary resuscitation fluid was given, then you can add the bolus to the total volume given.
Page 19 4. You may or may not see the Safety Questions screen. This screen asks if the patient is hypotensive, hyperglycemic, on pressors or on diuretics. These questions are asked when the algorithm recommends decreasing fluids. ALERT: If you answer yes to any of these questions, consult with the Attending Physician to determine appropriate fluid therapy.
Page 20 a. Note: In Monitor Only mode there is no UO- based recommendation. Monitor Only mode You have now completed the Hourly Fluid Update! You will be taken to the Home screen. Burn Navigator® User’s Manual Page 20...
Page 21: Patient Resuscitation Screens
Patient Resuscitation Screens The patient resuscitation screens show a top bar, a row of six tabs to select the six patient resuscitation screens, and a row of functional buttons along the bottom of the first three screens. Top Bar & Battery Indicator The top bar shows the Patient ID, patient weight and TBSA, the current Hour Post Burn (HPB), the battery indicator, and the current time.
Page 22: Hourly Update
Along the bottom of the Home, Patient and Notes screens is a row of Functional buttons. If “Enter Notes” feature is disabled in “Admin Settings”, then the Enter Notes button will not show on this row. If you are in “Training Mode”, then the far right button will be “Next Update” rather than “Screen Saver”.
Page 23: Enter Notes
When you press the End Decision Support button, you will be asked twice to confirm ending decision support for this patient. When you press the End Decision Support button, you will be asked to select a rationale for ending decision support. Enter Notes Pressing the Enter Notes button takes you to a keyboard screen for entering notes.
Page 24: Next Update
The last button will be either “Screen Saver” or “Next Update”: Screen Saver The screen saver button will darken the screen, helping preserve battery life. NOTE: When an hourly fluid update is due or there is another alert message, the screen saver will end and you will see the message. Next Update When you are in “Training Mode”, you will see “Next Update”...
Page 25 The Patient screen shows the Information you entered in the New Patient Setup. You may change the data in the white fields, except for the Protocol. The Burn Navigator start time (“BurnNav started”) is time stamped when you complete the New Patient Setup. The BurnNav started time cannot be changed.
Page 26: Notes
Notes The Notes screen has two sections. The Notes section on the left shows any notes that have been entered through the “Enter Notes” button, as well as various Burn Navigator- generated notes. The first note, “Resuscitation Plan” is automatically added based on the options chosen in the new patient setup.
Page 27: I/O Table
I/O Table The I/O Table shows all the fluid information for the patient. On the left of the screen is a list of fluids and other information: the UO (in mL and in mL/kg/hr), Recommended Rate for that time period, Actual Primary Fluids given to the patient, Total Adjunct Fluids, and Total Other Fluids.
Page 28: Volume
In the Hourly Averages view, each column represents exactly 60 minutes, matching clock hours. 2) Actual Times (on the right) indicates the values entered for the actual time period of the update. For example, the screen on the right shows one fluid update period ending at 11:01, one minute after the top of the hour.
Page 29: 24 Hour Fluid Projection
The volume graph shows the cumulative volume of all fluids (Primary and Adjunct resuscitation fluids) that the patient has received since the burn occurred. Note: The Cumulative Volume graph includes only primary and adjunct fluids. Other fluids are not included. There are four or five lines overlaying the volume graph: Green: Modified Brooke formula (2...
Page 30: I/O Graph
I/O Graph The I/O Graph indicates Fluids In on top portion of the graph and Urine Output on the bottom. Each bar is one clock hour (each hour post burn (HPB)). The data seen in the I/O Graph is the Hourly Averages data from the I/O Table.
Page 31: Urimeter Connectivity
Urimeter Connectivity The Burn Navigator can connect to a urimeter device to collect UO data. Currently, the following devices are supported: Manufacturer Device Name Adaptec SensicaUO You may connect a compatible urimeter at any time, before or after starting Burn Navigator. We suggest connecting the urimeter to Burn Navigator as soon as possible.
Page 32: Continuous Uo Graph
Continuous UO Graph The Continuous UO Graph tab will be visible only if your Burn Navigator is configured for urimeter connectivity. This graph displays the cumulative UO volume, as measured by the urimeter, over the current clock hour. Each point on the graph shows when UO data is collected.
Page 33 • When the infusion rate has been over 1,000 mL/hr for 6 or more hours The Volume graph has the Modified Brooke and Parkland resuscitation guidelines, as well as the 200 mL/kg/24 hours and 250 mL/kg/24 hours alert lines. The Volume graph also changes colors when the two alert levels are reached.
Page 34: System Functions
System Functions The System Menu includes: • Screen Saver time. This is the number of minutes of inactivity before the screen saver starts. (Note that the screen saver will not automatically start when in Training Mode) • Brightness. The brightness controls lets you brighten or dim the screen.
Page 35 • EMR Status. This button will take you to the EMR Status screen. Note: EMR connectivity requires additional IT setup. Please contact Arcos regarding EMR connectivity. Burn Navigator® User’s Manual Page 35...
Page 36: Transfer Active Patient
Transfer Active Patient To transfer an active patient from one Burn Navigator (“Tablet A”) to another Burn Navigator (“Tablet B”), do the following: Exporting the patient (Tablet A) 1) Insert a Burn Navigator® Data Drive into the USB port on Tablet A. 2) Select the “Transfer Active”...
Page 37: Faq - Frequently Asked Questions
You may also change your system time by selecting the “Tablet B” field. Note! For non-training patients, you cannot enter a time for Tablet A which is earlier than the time of the last fluid update. 5) Select “Import”. Note! The existing patient file data will be adjusted to correct for the difference between the clocks on Tablet A and Tablet B.
Page 38 of large additional fluids, then increasing the primary resuscitation fluid above the recommendation for the next hour when the large additional fluids are no longer given. 3. What if the doctor orders a bolus of my primary resuscitation fluid? a. There are two ways to include a bolus of the primary fluid, e.g. Lactated Ringer’s: 1) When you perform the hourly fluid update, on the ‘primary infusion rate’...
Page 39: Troubleshooting
Troubleshooting Starting Up Cannot start up. ● Connect the AC adaptor. The power indicator or ● Insert a fully charged battery. battery indicator is not ● Remove the battery pack and the AC adaptor, and then connect them again. lit. ●...
Page 40: Software Warnings, Alerts, And Messages
I see the Windows log-in • Select the “BRDSS” log-in. If you don’t see the “BRDSS” log-in option, press screen the “Cancel” button. Note: you will see the Windows log-out screen if you accidentally hit the ‘key’ functional button. Battery The battery indicator •...
Page 41 Cause of Alert or Message Alert or Message Text User selects a patient file to delete Conditional text: “Data from the previous patient will be erased. Data has/HAS NOT been archived. Are you sure you want to proceed?” User selects ‘yes’ to the first “Deleting “PLEASE CONFIRM: patient record when the record has not Data from the previous patient will be erased.
Page 42 Cause of Alert or Message Alert or Message Text It has been over 24 hours post burn and “Patient has been on minimum fluid rate for 6 or the patient has been at minimum fluid more hours and it is past 24 hours post burn. If all rate for at least 6 hours other parameters of adequate tissue perfusion are normal, you may end decision support for this...
Page 43 Cause of Alert or Message Alert or Message Text User changes the system date or time as “The system date/time and the local time-zone well as the time zone have been changed. Are you sure you want to proceed?” 48 hours post burn has been reached “Alert! It has been 48 hours post burn.
Page 44 Cause of Alert or Message Alert or Message Text The new recommendation exceeds “Alert! The new recommendation exceeds +/- +/- 25% from the current infusion rate 25% of the current rate and is at least a 100 mL/hr and is at least a 100 mL/hr change change.
Page 45 Cause of Alert or Message Alert or Message Text The user presses the Hourly Update “It is not yet time to do the hourly fluid update or button, but it is too late to redo the last the 10 minute edit window has expired. hourly update and it is not yet time for a new hourly update.
Page 46 Cause of Alert or Message Alert or Message Text When the EMR server receives a fluid “EMR rejected the update. Press “Resend Data” to update (or new patient info) and sends try again. If you get this error again, contact your a “rejected”...
Page 47 Cause of Alert or Message Alert or Message Text When Burn Navigator is set to Alert! The Burn Navigator is configured to automatically time sync with your automatically time sync with your server. Dock the network and you try to manually Burn Navigator to sync the time.
Page 48 38-M-1 Wireless LAN / Bluetooth The Wireless LAN / Bluetooth on this device has been disabled. Arcos is not responsible for any radio, television, or third party equipment interference caused by unauthorized modification of this product. Arcos and its authorized resellers or distributors are not liable for damage or violation of government regulations that may arise from failing to comply with these guidelines.
Page 49 Lithium Battery! This computer contains a lithium battery to enable the date, time, and other data to be stored. The battery should only be exchanged by authorized service personnel. Warning! A risk of explosion from incorrect installation or misapplication may possibly occur. 15-E-1 Information for Users on Collection and Disposal of Old Equipment and used Batteries If you wish to discard this product, please contact your local authorities or dealer and ask for the correct...
Page 50 Close the Connector Cover Tightly When Using This Product Where Is a Lot of Water, Moisture, Steam, Dust, Oily Vapors, etc. The entry of foreign matter may cause a fire or electric shocks. • If foreign matter has found its way inside, immediately turn the power off and unplug the AC cord, and then remove the battery pack.
Page 51 Use only the specified battery pack with your product. Use of battery packs other than those manufactured by Getac or supplied by Arcos may present a safety hazard (generation of heat, ignition or rupture). When the battery pack has deteriorated, replace it with a new one Continued use of a damaged battery pack may result in heat generation, ignition or battery rupture.
Page 52 • In high-temperature environments, the battery takes longer to fully recharge and the operating time is shorter. Only use the computer within the allowable temperature range. • This computer has a high temperature mode function that prevents the degradation of the battery in high temperature environments.
Page 53 *1 1 KB = 1,024 bytes / 1 MB = 1,048,576 bytes / 1 GB = 1,073,741,824 bytes *2 A segment of the main memory is allotted automatically depending on the computer’s operating status. The size of the Video Memory cannot be set by the user. The size of Video memory is allotted depending on the operating system. *3 1 MB = 1,000,000 bytes / 1 GB = 1,000,000,000 bytes.
Page 54 Guidance and manufacturer’s declaration – electromagnetic immunity The Burn Navigator® is intended for use in the electromagnetic environment specified below. The customer or the user of the Burn Navigator® should assure that it is used in such an environment. IEC 60601-1- Electromagnetic environment - Immunity test 2:2014 test level...
Page 55 Guidance and manufacturer’s declaration – electromagnetic immunity The Burn Navigator® is intended for use in the electromagnetic environment specified below. The customer or the user of the Burn Navigator® should assure that it is used in such an environment. 60601-1- 2:2014 Compliance Immunity test...
Page 56 NOTE 2 These guidelines may not apply in all situations. Electromagnetic propagation is affected by absorption and reflection from structures, objects, and people. The Burn Navigator RX did not require a deviation from the IEC 60601-1-2: 2014 product standard. Only U.S. power ranges were tested (110-120 V, 60 Hz).
Page 57: Service & Technical Support
Trademarks All brand and product names are trademarks or registered of their respective owners. Burn Navigator® is a registered trademark of Arcos, Inc. Microsoft®, Windows® and the Windows logo are registered trademarks of Microsoft Corporation of the United States and/or other countries.
Page 58 Index Admin Settings, 34 Battery Alerts, 44 Indicator, 21 Information, 49 Inserting and About, 9 Precautions, 50 Preserving (screen saver and brightness), 34 Spare, carrying, 7 Specifications, 52 Troubleshooting, 40 Brightness Changing, 34 Troubleshooting, 39 Checklist, 16 EMR (Electronic Medical Record) EMR Status, 35 Frequently Asked Questions (FAQ), 37 Hourly Update...
Page 59 Notes Burn Navigator® User’s Manual Page 59...

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