Arcos Burn Navigator Setup guide

Burn Navigator®
Super User Training Guide
Slides © 2019 Arcos, Inc. June 2019
For Burn Navigator RX
Version V.6.1e-V.6.1h

Super Users
Thank you for being a Super User!
Be sure to also review the basic
Burn Navigator Training Guide
2

Tablet Characteristics
•Rugged
–High heat & humidity capable
–Water & fluid resistant
–Can be used during debridement!
•Battery Life
–6 hours
–you can swap the battery without
shutting down the system
3

4
The pre-hospital
fluids are not used
in the algorithms
However, these fluids are used in the graphs
and the I/O Table
A patient may have urine
in the bladder from
before the burn

5
Choose “Monitor only”
mode for patients:
•<10 kg
•<24 months old
•Other conditions
affecting urine output
We can use Monitor Only
mode data to build future
protocols

6
Primary Fluid types:
The “Primary Fluid” is titrated up
and down.
“Additional Fluids” are not titrated
The Primary Fluid could be an
“albumin protocol”

7
Initial Formula:
Administrators can set the
default starting formula
ABLS guidelines recommend 2
mL/kg/TBSA for most adult
burns
Consider higher starting
rates for:
- Electrical injuries
(4 mL/kg/TBSA)
- Inhalation injuries
This is just for the starting
rate! Later recommendations
are based on UO.
If a formula goes above 2,000 mL/hr,
or below the minimum rate, Burn
Navigator will recommend one of
those limits instead.

8
Fluid updates are due at the top of each clock hour (__:00),
unless the last “To” time was 15 or less minutes ago
E.g., device started at 12:46, next update will be at 14:00

Additional Fluids
9
You’ll see this warning
message anytime
additional fluids are
given, because the
algorithm doesn’t
take those fluids into
account.
However, Burn
Navigator will adjust
down on LR if there is
higher UO due to
additional fluids!

Patient on Pressors?
10
If your patient is on
pressors, ask the
attending doctor
whether you can wean
the patient off pressors
before reducing fluids

Volume Graph
11
The graph
increments every
minute based on
the current rate
All fluids (with the
exception of “Other
Fluids” from the
Additional Fluids
section) are
averaged over the
time period of each
update.
Guidelines can be turned on or off here

I/O Graph
12
Scroll buttons to see data beyond 24 hours

1140
1280
1430
1570
1710
1850
2000 2000 2000 2000 2000 2000 2000
500 570 630 690 750 820 880 940 1000 1070 1130 1190 1250
100 120 130 140 150 170 180 190 200 220 230 240 250
40 45 50 55 60 65 70 75 80 85 90 95 100
Recommendation Window
First 8 Hours Post Burn
Max
Min if 100% TBSA
Min if 20% TBSA
Weight (kg)
Rates (mL/hr)
13
Max = 28.6 xkg
up to 2,000 mL/hr
Minimum
recommendation
depends on %TBSA
Applies to both
Adult Predictive
and Weight-based
protocols

New Projection Safety
14
The software won’t recommend increasing the IV fluid rate if the 24 hour fluid
projection is too high. (The “too high” level is set on the Clinical Admin screen.)

System Functions
15
Screen saver
timer
Screen
brightness
Advance Time: For training mode
only, this feature lets you add
minutes to get to the next fluid
update quickly.
Transfer your active patient to a USB
data drive (for another Burn Navigator). Move to USB or
delete inactive
patient files.
Properly turn off
the device.
Note: Turning
off the system
during training
mode will reset
the clock.
Change the
time-zone,
date, or
time.
Security,
Clinical
& EMR
settings
Shows EMR
status and any
error messages

Maintenance
•Clean the device after each patient!
–Use a disinfectant wipe, per your hospital’s policy, to
clean the screen and whole device.
•Keep batteries fully charged when not in use.
•Quarterly, delete patient files
•Change System Time for Daylight Savings!
(2x each year)
16

Burn Navigator® Data Tool
•The Data Tool is a separate program that
converts encrypted patient files into PDF and
Excel CSV files.
•See the Data Tool’s instructions for use (IFU-
1130) for a step-by-step walkthrough.
17

Early O.R.
What happens when the patient goes to the O.R.
during resuscitation (“early” O.R.)?
E.g., patient goes at 1348 and returns at 1748. The
patient received 4 units of whole blood, 2 units FFP,
5,000mL of LR, and had a UO of 200mL.
If the physician wants you to continue the Burn
Navigator after “early” O.R. excising, you can:
•Do one fluid update at 1748 that covers the entire
OR time. Enter all the fluid and UO in that update.
The device will average the fluids over those 4 hours
and will provide a new recommendation.
•Ask the doctor what rate to use after OR.
18

“Early” O.R. Example
19

Burn Navigator®
Questions?
Arcos customer support:
877.542.8025
[e-mail]