Case Flows demonstration - User Experience Video

Hello, ladies and gentlemen, my name is Martin Austermann. I head the Clinic for Vascular Surgery and Phlebology at St Franziskus Hospital in Münster. Every year, we treat about 3000 patients a year for surgical diseases on the vessel, both openly, but also primarily endovascularly, i.e. minimally invasive. I would like to show you a special situation for this plant, which is the so-called cash flows. Of course, this plant is extremely complex. We need to determine what programme of investigation we would like to have. We have to determine how the table should be positioned, how the C amp should be positioned and that for each individual procedure. To standardize that. Or does Siemens supply us? The so-called cash flows, where we can preset everything, can be stored, then we can retrieve it during the investigation and do not have to worry so much about it anymore, but we know that I do this or that procedure and then I choose this associated cash flow on the one that allows me, that this presetting allows, and I may perhaps show you the example of an aortic procedure. So we want to have a dummy patient with a patient here. Already prepared on the abdominal aorta treat, for example, on a ruptured embauche folder Isma, where everything has to go very quickly, so we just have the possibility of cash flows. You can see here the system in the basic setting in the so-called parking position of the C arch is outside you can prepare everything the patient is put on the table, the anesthesiologist can prepare them. Narcotize. Whatever the op's sister has. In this front area, to prepare their materials, under sterile cauts and that of the patient can be covered off. So and then I just go and decide. I would like to perform an Eva procedure an endovascular aortic repair. Select this cash flow. Then I move to this position, what the vessel does, what the device does, it moves the table to the correct position. The C arm is moved to the correct position and the device selects the right examination program for the right person. When the device has reached this position, we get a sign. And this thing dong and we can start our procedure. So you see here the C bow is retracted from head heart, the patient is well prepared, the anesthesia has worked, the surgical nurse has worked. We could start our procedure right now without worrying about these many other circumstances, but if I now have a patient, for example, I do not want to operate on the abdomen, but I want an angiography. Carrying out or treating the legs Endovascular then I also have other cash flows and here we have, for example, the cash flow extremities and when I drive it on yes, then the device moves quasi in a different position they see that. Here is now quasi from the left to the patient in, that I then have the possibilities from there to examine both the abdominal vessels, but also the leg vessels. The device drives all movements automatically, so there are motors for all directions of movement and that of course allows us to have a great degree of freedom. Now the table moves into the right position and the usual angiography starts in the pool and we are right there when I am there. Before a procedure or during a procedure comes to mind. I actually need a special other cash flow mechanism that I would like to save, then this is very, very simple and I drive the C arm the table into the correct position. I am setting up the right programme of investigations, and I would like to demonstrate that to you. For example, we would like to perform an antegrade angiography of the left leg, ne, then I would first drive the table into the position here, so that I can start this procedure on the thigh. Maybe it should. Picturer even closer to the patient the radiation protection wants the table maybe a little higher, so I have the ideal conditions, then I look at myself I have then chosen the right examination and choose the right examination. I just take DSA extremities for the sake of simplicity then the device is set so that this might be okay for me. But I can also reduce the pulse rate, for example, whatever I imagine. So and if I agree with everything and think to myself like this, so I want to start now any anti straight angiography of the left leg, then I go back here to my cash flow screen. I'm going for new new cash flow. But if I do. Don't need any features at all can I also turn them on or off? And on this first page where I enter the name, I find different stories that I need or don't need. For example, if I need imaging, I choose the examination program, which is what I need, but if I do not want to have it specifically defined, then I leave the way and deactivate it. I can change the layout of the overview screen, so I can say, for example, I want any other. Anti grade angiography controlled with ultrasound point yours, then I can set this in advance that I always right overseas. Screen ultrasound image and that can then change later or the table position I can take in or I say I do not need a special table position for this cash flow now, then I just let it out like that and then a page appears where I can first enter the name that I do now, I write that now in. Antegrad. Left. Save that. So I think maybe I was able to explain to them a little bit that these cash flows in everyday clinical practice have their meaning and of course can be helpful especially for perhaps inexperienced colleagues perhaps for situations on night duty, so that you do not have to worry about the many fine adjustments. In this respect, I believe that this is a good idea and an important feature, which may take up even more space in the future and I would like to conclude and thank you very much for your attention.

385 7.0 -7.0 123 Case Flows demonstration St. Franziskus-Hospital Münster Good afternoon, ladies and gentlemen, My name is Martin Austermann. PD Dr. med. Martin Austermann Specialist for general and vascular surgery, Phlebology and enido ascular Surgery at the St. Franziskus-Hospital in Münster I am the head of the Clinic for Vascular Surgery and Phlebology at the St. Franziskus Hospital in Münster. Every year we treat approximately 3.000 patients Approximately 3000 patients who have vascular disorders per year Primarily endovascular procedures 400 of the 3000 patients are treated for aortic aneurysms who have vascular disorders requiring surgery, performing some open surgical procedures, but primarily endovascular, this means minimally invasive, procedures. SIEMENS Heolthineers I would like to show you the so-called Case Flows. The system is of course extremely complex. For example, we have to specify what exam protocol we would like to have, how the table and the C-arm needs to be positioned. This needs to be done for each individual procedure. In order to standardize this, Siemens Healthineers provides us with the Case Flows, where we can set all this in advance and save it. During the examination we can then retrieve these, without the need to think about it, simply be aware of which procedure you are performing. Then I select the appropriate case flow which allows me to use this presetting. I want to demonstrate you this today, using the example of an aortic procedure. So, we have a patient who has already been prepared and we would like to work on the abdominal aorta, for example on a ruptured abdominal aortic aneurysm - where everything has to proceed very quickly. We have the option here ARTIS Examination Display C-Arm Position Table Detector RDMP & Overlay OK Tools Favorites se Flows Exam of using the Case Flows. EVAR / TEVAR DSA PELVIS DSA EXTREMITIES Sys. Pos. Case Flows Here you can see the system in the default setting, which we call the parked position. The C-arm is outside. Everything can be prepared, then the patient is placed on the table and the anesthetist can prepare the anesthetic. The operating-room nurse has this front area for preparing some materials under sterile conditions, and the patient can be covered. Then I decide that I perform an EVAR procedure, an endovascular aortic repair, DSA Extremities ELVIS Then I select that case flow. Cancel Auto Drive Automatic run: Calculating path ... Drive to Position Automatic run: Deflect joystick to move to target position Hold to Drive and move the system to this position. id to Drive Automatic run: Moving to target ... to Drive The system then moves the table to the correct position. The C-arm is also moved to the correct position ARTIS icono and the system selects Adjusted Settings: Table position C-arm position Imaging parameters Large Display layout Overlay the correct exam protocol. When the system has reached its position, we hear a ding dong- signal - and we can begin our procedure. So you can see here that the C-arm is located above the patient's head, the patient himself is well prepared, the anesthetic has worked, and the operating-room nurse has done her work. Now we could directly start with our procedure without having to concern ourselves with these many other details. But if, for example, I have a patient who does not require an operation on the abdomen but on whom I have to perform an angiography of the legs - endovascularly - then there are other Case Flows I can use. Fa Here we have the case flow Extremities. When I start this case flow, the system moves to a different position; you can see that here, it is moving from the left in toward the patient, so from that position I have the options of examining both, the abdominal and the leg vessels. The system performs all movements automatically, this means there are motors for all movement directions, and this of course gives us a high degree of freedom. Now the table moves to the correct position and the usual angiography begins in the pelvis and we are right here on the spot. If, before or during a procedure, it occurs to me that I actually need a different specific case flow which I would like to save, then that is very, very easy. To do this, I move the table to the correct position. I select the right exam protocol, and I would like to demonstrate this now. For example, we would like to perform an antegrade angiography of the left leg. Here, I first move the table to the correct position so that I can begin this procedure at the femur. Perhaps the detector should be even closer to the patient? The table should be a little higher. So now I have the ideal preconditions. Then I select the right exam protocol. For the sake of simplicity, I now simply select DSA Extremities; the system is then adjusted so that it is right for me. I could, however, also reduce the pulse frequency, or whatever I want. When I am happy with everything and if I would like to start all other antegrade angiographies System Positions Patient Transfer Left Side Right Side Head Side Left Side, Table Rotated of the left leg in this way in future, Flows Then I select on the case flow screen New. New Rename Layout Detector & Collimator There are various parameters which I can select or deselect. In this field, where I can enter the name, I can also select or deselect certain settings, that I do or do not need. For example, Imaging means the selection of the exam protocol that I want to save in the case flow. If I do not want to have that specifically defined, then it can also be disabled. I can adapt the layout of the large display - for example, I can define to have every other antegrade angiography punctured in control of ultrasound. Then I can specify that ultrasound is always displayed Ultrasound NR pheno Aneuclips 3D, 2D MHH, IR 3 ... ANL 0.0 dB NO XRAY - Close door Live on the right in the large display. -14cm Play 0.0 ms Pause This can later also be changed again, as required. I could also include the table position. If I don't need a specific table position for this case flow then I simply deselect it. Then a page appears where I can enter the name. I write in this case Antegrade Left and save it. space ace ANT ANTEGRAD ANTEGR' ANTEGRAD L I hope I have been able to show you that Case Flows definitely Case Flows can standardize individual procedures Focus can remain on the patient treatment - not on the technical system settings. have a place in daily clinical practice and can of course be particularly helpful for inexperienced colleagues and situations that occur on the night shift. All the necessary settings are made automatically. For this reason, I believe the saving of Case Flows is an important feature which may become even more relevant in future. And with that I would like to close. Thank you for your attention. Ca The information presented in the videos is for illustration only and is not intended to be relied upon by the reader for instruction as to the practice of medicine. Any health care practitioner reading this information is reminded that they must use their own learning, training and expertise in dealing with their individual patients. This material does not substitute for that duty and is not intended by Siemens Medical Solutions to be used for any purpose in that regard. The treating physician bears the sole responsibility for the diagnosis and treatment of patients. The Operating Instructions must always be strictly followed when operating the Angiography System. Siemens Healthineers are neither the provider nor legal manufacturer of this video. Any claims and statements made in this video and any content shown in the video are under the sole responsibility of the provider. Additionally, the training may not be available in all countries and the content may not be commercially available in all countries. Please contact the provider for more information. Healthineers