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when do infusions end? #43

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corcra opened this issue Jan 15, 2018 · 4 comments
Open

when do infusions end? #43

corcra opened this issue Jan 15, 2018 · 4 comments

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@corcra
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corcra commented Jan 15, 2018

Looking at the infusiondrug table: I assume the corresponding time (or offset) indicates when the infusion was started. However, I am not sure how to say when that particular infusion ended. Is this recorded somewhere?

My guess would be to look at the amount of fluid (volumeoffluid), assume the rate (infusionrate) is in units corresponding to whatever is in the drugname, and figure out how long it took to give that volume of fluid. However, aside from being somewhat convoluted, not every infusion has a volumeoffluid value (some are NaN) so this would fail in many cases and I really don't want to discard values like that.

@alistairewj
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The challenge here is that documentation practices vary. One hospital may only manually document infusions every shift, while some will have hourly documentation as they have an interface integrating data from a bedside information system. There's no easy fix to this!

Also, I believe volume of fluid is actually the amount of fluid in the bag containing the drug, and is used to determine drug concentration.

@alistairewj
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See here for more info: http:https://eicu-crd.mit.edu/eicutables/infusionDrug/

@rincont
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rincont commented Jan 16, 2018

Alistair is correct. The interface of dose and rate for continuous infusions has only been accomplished at a few sites. This is generally due to limitation on the sending side (e.g. the source EHR). This forces most sites to rely on interface of the volume infused and not the hourly dose and rate changes. This is not as straight forward or intuitive as it could and should be for the nurse. This leads to errors in documentation. For example, the source EHR vendor we use claims that they cannot send the dose and rate data so we are forced to interface the volume infused. The nurse documents the dose in the source EHR which in turn auto-changes the rate. Unfortunately, the nurse must then manually confirm the volume infused. Once that is done then the information can be interfaced. By using the medication table to determine the concentration, one can calculate the dose infused. It will be difficult to figure out the exact time a med was stopped. Using the drug stop time variables from the medication table may assist in getting close. http:https://eicu-crd.mit.edu/eicutables/medication/

@corcra
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corcra commented Jan 24, 2018

Can you explain how to use the medication table to determine the concentration, or ideally the given dose?

I can see there are start and stop times for the drug, which is getting to what I want with the original question. But as for finding out how much drug was given, all I see is dosage and guessing based on the drugname (assuming the patient is receiving whatever quantity may be included). The dosage field is unfortunately rather opaque; it has many values like 600 3, 1 5001, or 3.375 g, 70 mL/hr.

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