01:47:12
Induction 06:12 · Incision 06:41
14 doses
Last: Fentanyl 50 µg
1450 ml
RL 900 · Colloid 550
320 ml
Urine out 480 ml
Live Patient Monitor
Streaming
Sweep 25 mm/s
ECG II
HRbpm
72
Sinus · PVC 0
SpO₂ Pleth
SpO₂%
99
Perf 4.2
Capnography EtCO₂
EtCO₂mmHg
36
RR 12 · FiO₂ 50%
ART / NIBPmmHg
118/74
MAP 89 · 14:32
Temp (core)°C
36.4
Nasoph. probe
AgentMAC
0.9
Sevo 1.8%
Systolic ▽ / Diastolic △
Heart rate ●
SpO₂
Case duration 0 → 110 min · grid 10 min
| Time | Agent / Fluid | Type | Dose / Vol | Route | By |
|---|
WHO Surgical Safety Checklist
0/0
OR Schedule Board — 15 Jul
07:00 – 19:00
07091113151719
In progress
Completed
Scheduled
Fluid Balance
running total
Total In
1450 ml
Total Out
800 ml
EBL
320 ml
Net Balance
+650 ml
Urine output vs target (0.5 ml/kg/h)
Completed
Dr. R. Nair · 14 Jul 18:20
III
Systemic disease · CAD, DM-2, HTN
II / IV
Predicted difficult: No
FIT
High-risk consent obtained
Clinical History & Examination
Presenting complaint: Exertional angina (CCS II) ×6 months, breathlessness on climbing 1 flight. CAG → triple-vessel disease (LAD 90%, LCX 80%, RCA 75%). Advised elective CABG.
Past history: Type-2 Diabetes ×11 yr (on Metformin + Glimepiride), Hypertension ×9 yr (Telmisartan 40 mg OD), ex-smoker (stopped 3 yr, 20 pack-yr). No prior anaesthetic exposure. Allergy: Penicillin (rash).
Examination: Wt 74 kg · Ht 171 cm · BMI 25.3 · Pulse 78/min reg · BP 138/86 · SpO₂ 98% RA · Chest clear · CVS S1S2 no murmur · Neck movements full · TMD 6.5 cm · Dentition intact.
Fasting: Solids 8 h · Clear fluids 2 h · Morning anti-hypertensives given with sip of water. Metformin & oral hypoglycaemics withheld on day of surgery.
Past history: Type-2 Diabetes ×11 yr (on Metformin + Glimepiride), Hypertension ×9 yr (Telmisartan 40 mg OD), ex-smoker (stopped 3 yr, 20 pack-yr). No prior anaesthetic exposure. Allergy: Penicillin (rash).
Examination: Wt 74 kg · Ht 171 cm · BMI 25.3 · Pulse 78/min reg · BP 138/86 · SpO₂ 98% RA · Chest clear · CVS S1S2 no murmur · Neck movements full · TMD 6.5 cm · Dentition intact.
Fasting: Solids 8 h · Clear fluids 2 h · Morning anti-hypertensives given with sip of water. Metformin & oral hypoglycaemics withheld on day of surgery.
Pre-Operative Investigations
14 Jul 2026
| Investigation | Result | Reference | Flag |
|---|---|---|---|
| Haemoglobin | 13.4 g/dL | 13–17 | Normal |
| Total leucocyte count | 8,200 /µL | 4k–11k | Normal |
| Platelet count | 2.28 L/µL | 1.5–4.1L | Normal |
| INR | 1.1 | 0.8–1.2 | Normal |
| Serum creatinine | 1.3 mg/dL | 0.7–1.3 | Borderline |
| Na⁺ / K⁺ | 139 / 4.2 | 135–145 / 3.5–5 | Normal |
| Fasting blood sugar | 156 mg/dL | 70–110 | High |
| HbA1c | 7.8 % | <6.5 | Elevated |
| ECG | ST-T changes, inferior leads | — | Abnormal |
| Chest X-ray | Cardiomegaly, clear lung fields | — | Note |
| 2D-Echo (LVEF) | 42 % | >55 | Mild LV dysf. |
| Blood group / cross-match | B+ · 2 units PRBC | — | Ready |
Airway & Risk Grading
III
II
6.5 cm
> 3 cm
Full
No
Low (NPO 8h)
3.8 %
Class III
Consent & Pre-Op Checklist
Informed high-risk surgical consent signed
Patient + son · 14 Jul 19:05
Anaesthesia consent (GA + invasive lines)
Dr. R. Nair · 14 Jul 18:20
Blood transfusion consent · 2 units cross-matched
Blood bank · 15 Jul 05:40
Site marked & surgical safety wristband verified
Nurse · 15 Jul 06:00
ICU bed reserved (post-op ventilation)
CTVS-ICU · Bed 4
Dentures / jewellery / prosthesis removed
Pending ward handover
14
Since induction 06:05
1450 ml
Crystalloid 900 · Colloid 550
1 unit
PRBC · 1 unit standby
2
Noradrenaline · Sevoflurane
Intra-Operative Medication & Fluid Ledger
OT-3 · 15 Jul
| Time | Agent / Fluid | Type | Dose / Vol | Route | Running Total | By |
|---|---|---|---|---|---|---|
| 06:05 | Glycopyrrolate | DRUG | 0.2 mg | IV | — | RN |
| 06:08 | Midazolam | DRUG | 2 mg | IV | — | RN |
| 06:11 | Fentanyl | DRUG | 150 µg | IV | 150 µg | RN |
| 06:12 | Propofol | DRUG | 120 mg | IV | — | RN |
| 06:13 | Rocuronium | DRUG | 50 mg | IV | — | RN |
| 06:14 | Ringer Lactate | FLUID | 500 ml | IV | 500 ml | ST |
| 06:20 | Sevoflurane | AGENT | 1.8 % | Inh | MAC 0.9 | RN |
| 06:41 | Cefuroxime | DRUG | 1.5 g | IV | — | RN |
| 07:02 | Heparin | DRUG | 25,000 U | IV | ACT 480s | RN |
| 07:15 | Ringer Lactate | FLUID | 400 ml | IV | 900 ml | ST |
| 07:40 | Voluven (colloid) | FLUID | 550 ml | IV | 1450 ml | ST |
| 07:52 | Noradrenaline | DRUG | 0.05 µg/kg/min | Infusion | running | RN |
| 08:05 | Tranexamic acid | DRUG | 1 g | IV | — | RN |
| 08:12 | PRBC (B+) | BLOOD | 1 unit | IV | 1 unit | ST |
| 08:20 | Fentanyl | DRUG | 50 µg | IV | 200 µg | RN |
IV Fluids — Running Totals
Ringer Lactate
900 ml
Colloid (Voluven)
550 ml
Total Crystalloid + Colloid
1450 ml
Urine Output
480 ml
Fluid input rate (target 4–6 ml/kg/h)
Blood Products
Cross-matched B+
| Product | Bag No. | Status | Time |
|---|---|---|---|
| PRBC · Unit 1 | BB-2026-4471 | Transfused | 08:12 |
| PRBC · Unit 2 | BB-2026-4472 | Standby (OT) | — |
| FFP · 2 units | BB-2026-4488 | Reserved (BB) | — |
| Platelet conc. | — | Not indicated | — |
5 / 6
OT-6 under maintenance
13
6 done · 3 live · 4 scheduled
2
1 LSCS · 1 Appendix
78 %
First-case delays: 2
OR Schedule Board — 15 Jul 2026
07:00 – 19:00
07091113151719
In progress
Completed
Scheduled
Today's Case List
| OT | Time | Procedure | Surgeon | Anaesthetist | Status |
|---|---|---|---|---|---|
| OT-1 | 07:30 | Lap. Cholecystectomy | Dr. Menon | Dr. Kapoor | Completed |
| OT-1 | 09:30 | Total Knee Replacement (L) | Dr. Bhatt | Dr. Kapoor | In progress |
| OT-1 | 13:00 | ORIF Femur | Dr. Rao | Dr. Kapoor | Scheduled |
| OT-2 | 07:00 | LSCS (emergency) | Dr. Pillai | Dr. Shah | Completed |
| OT-2 | 09:00 | TURP | Dr. Khan | Dr. Shah | Completed |
| OT-2 | 12:30 | Whipple's Procedure | Dr. Sinha | Dr. Shah | Scheduled |
| OT-3 | 06:12 | CABG ×3 — A. Kulkarni | Dr. S. Iyer | Dr. R. Nair | In progress |
| OT-3 | 13:00 | Mitral Valve Replacement | Dr. S. Iyer | Dr. R. Nair | Scheduled |
| OT-4 | 08:00 | Thyroidectomy | Dr. Das | Dr. Mehta | Completed |
| OT-4 | 10:30 | Modified Radical Mastectomy | Dr. Reddy | Dr. Mehta | In progress |
| OT-4 | 13:30 | Hernia Mesh Repair | Dr. Verma | Dr. Mehta | Scheduled |
| OT-5 | 07:30 | Craniotomy (tumour excision) | Dr. Nambiar | Dr. Ghosh | Completed |
| OT-5 | 11:00 | Lumbar Spine Fusion | Dr. Joshi | Dr. Ghosh | Scheduled |
287
+8% vs last month
142 min
Turnaround 34 min
78 %
Target ≥ 85%
81 %
Prime-time 07:00–17:00
Cases per Day — this week
Avg Duration by Specialty
Cardiothoracic248 min
Neurosurgery205 min
Orthopaedics128 min
General Surgery96 min
Obs & Gynae64 min
On-Time Start % — 6 month trend
OT Utilisation by Theatre
OT-1 Ortho
88%
OT-2 GI / Uro
84%
OT-3 Cardiac
92%
OT-4 General
71%
OT-5 Neuro
79%
Cancellation rate
4.1%
5 / 6
1 degraded
4,182
ADT 2,140 · ORM 918 · ORU 1,124
99.6 %
14 NAK · 3 queued
0.42 s
HL7 v2.5.1 · MLLP
Interface Feeds
| Interface | Type | Source System | Direction | Msgs / day | Status |
|---|---|---|---|---|---|
| Patient Registration | ADT^A01/A04 | HIS (iSoft) | Inbound | 2,140 | Connected |
| OT Booking / Orders | ORM^O01 | HIS Scheduler | Bi-directional | 918 | Connected |
| Lab Results | ORU^R01 | LIS (Siemens) | Inbound | 1,124 | Connected |
| Radiology / PACS | ORU^R01 | PACS (Carestream) | Inbound | 312 | Degraded |
| Pharmacy Dispense | RDE^O11 | e-Pharmacy | Outbound | 466 | Connected |
| Billing / Charges | DFT^P03 | Finance (SAP) | Outbound | 402 | Connected |
Message Log
Live
| Timestamp | Message Type | Control ID | Patient / Ref | Ack |
|---|---|---|---|---|
| 08:34:12 | ORU^R01 | MSG-88241 | MH-CTVS-004821 · ABG | AA |
| 08:33:47 | ADT^A08 | MSG-88240 | MH-ORT-004902 | AA |
| 08:33:05 | ORM^O01 | MSG-88239 | OT-2 · Whipple booking | AA |
| 08:31:58 | ORU^R01 | MSG-88238 | PACS · CXR pending | AE |
| 08:30:22 | RDE^O11 | MSG-88237 | Pharmacy · Heparin 25kU | AA |
| 08:29:10 | ADT^A01 | MSG-88236 | MH-GS-004915 admit | AA |
| 08:28:44 | DFT^P03 | MSG-88235 | Charge · OT-3 consumables | AA |
| 08:27:31 | ORU^R01 | MSG-88234 | LIS · Creatinine result | AA |
| 08:26:03 | ORU^R01 | MSG-88233 | PACS · retry queued | NAK |
42
Across 6 role groups
17
8 in-theatre · 9 clinical
3,914
Immutable · WORM store
6
RBAC policy enforced
User Roles & Permissions (RBAC)
| User | Role | Department | Access Scope | Status |
|---|---|---|---|---|
| Dr. Renuka Nair | Consultant Anaesthetist | CTVS | Full chart · sign-off | Active |
| Dr. S. Iyer | Surgeon | Cardiothoracic | Op notes · orders | Active |
| Sr. Lakshmi Menon | OT Nurse (Scrub) | OT-3 | Charting · counts | Active |
| Suresh T. | OT Technician | OT-3 | Fluids · devices | Active |
| Dr. A. Kapoor | Resident (PG) | Anaesthesia | Charting (co-sign) | Restricted |
| Ravi Deshmukh | Biomedical Engineer | Biomed | Device config only | Active |
| Priya Nair | Records / MRD | Medical Records | Read-only · export | Active |
| admin.shalyachart | System Administrator | IT | Config · user mgmt | Elevated |
Audit Trail — Access Log
tamper-evident
| Timestamp | User | Action | Object | IP / Workstation | Result |
|---|---|---|---|---|---|
| 15 Jul 08:34:41 | Dr. R. Nair | ADMINISTER_DRUG | Fentanyl 50µg · UHID 4821 | OT3-WS-02 | Allowed |
| 15 Jul 08:20:09 | Suresh T. | RECORD_FLUID | PRBC 1u · UHID 4821 | OT3-WS-04 | Allowed |
| 15 Jul 08:05:52 | Dr. A. Kapoor | SIGN_OFF_RECORD | Anaesthesia record | OT3-WS-02 | Denied · needs co-sign |
| 15 Jul 07:41:16 | Sr. L. Menon | UPDATE_CHECKLIST | WHO Time-Out | OT3-WS-01 | Allowed |
| 15 Jul 06:41:02 | Dr. S. Iyer | CREATE_OP_NOTE | CABG ×3 · UHID 4821 | OT3-WS-03 | Allowed |
| 15 Jul 06:12:33 | Dr. R. Nair | START_CASE | Case #CT-4821 | OT3-WS-02 | Allowed |
| 15 Jul 06:02:18 | Priya Nair | EXPORT_RECORD | Discharge summary (PDF) | MRD-WS-11 | Allowed |
| 15 Jul 05:58:47 | unknown | LOGIN_ATTEMPT | User: iyer.s | 10.4.2.88 | Denied · bad password |
| 15 Jul 05:40:12 | admin.shalyachart | GRANT_ROLE | Resident → co-sign scope | IT-WS-01 | Elevated |
ShalyaChart · Electronic Charting Software Solution for Operating Rooms · On-Premise · Per-OT Perpetual Licence
PreOPIntraOPPostOPMedication MgmtFluid & NutritionHL7 IntegrationAnalytics & DashboardRBAC + Audit
MDR 2017 compliant · CDSCO licensed
GeM • Government of India · Demo build · Data simulated