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Descripción:
Principles/History of GAPS:
One of the most important elements of
anesthesiology practice is the preoperative assessment and preparation
of patients for anesthesia and surgery. A pre-anesthetic evaluation is
considered a basic element of anesthesia care. Cardiovascular disease
remains the most common major medical problem encountered in the
Perioperative period in the U.S.A and other developed countries. Of
the 27 million patients that undergo surgery in this country,
approximately 8 million are estimated to have either documented
coronary artery disease or at least one risk factor for cardiovascular
disease. This problem is further exacerbated by the increasing age of
the population, making cardiovascular disease one of the most
important public health related issues faced by the medical community.
It is no surprise that
algorithms have been developed to help in the evaluation of patients
undergoing elective and emergent surgical procedures. One of the most
widely known and widely used algorithm is published periodically by
the American College of Cardiology–American Heart Association Task
force on Perioperative Cardiovascular Evaluation for Non-cardiac
Surgery. The AHA in an effort to aid practitioners, distributed cards
and posters -with the step wise approach- so people in charge of
perioperative evaluation could have a handy piece of paper and point
of reference close by, when dealing with the evaluation of patients
undergoing non-cardiac surgery.
My interest was to
change this method of education in to a more sophisticated,
electronic, interactive, point of care, user friendly system that
could include the proposed guidelines and algorithm. PDA’s have been
used in virtually every medical field. Advances in computer technology
have made them almost essential in current medical practice. By 2005,
it is estimated that at least 50% of US physicians will use personal
digital assistants. Their portability, multifunctional capabilities
and their relative ease of use make them an attractive alternative for
point-of-care clinical reference and patient management devices.
Thanks to an
educational grant by the University of Florida and COMEC, today I
bring you G.A.P.S (Gainesville, Anesthesiology PDA, software program)
a project that thanks to my awesome (and patient) team has been in the
making since September 2003. We have incorporated the proposed
stepwise strategy for preoperative evaluation for non cardiac surgery
into electronic PDA/web interactive format, that provides the user
with a portable, point-of-care, handheld tool for perioperative
evaluation of patients with, or at risk for, cardiovascular disease.
Our initial goal was to incorporate the algorithmic approach and then
learn and grow from there. But my teammates accepted my "requests" and
we decided to include other pieces of information relevant to
anesthesiologists. I want to sincerely thank not just my team but the
many people that one way or another helped get GAPS going (MEM, HVO)
my most sincere gratitude. We hope you enjoy using this tool.
Dr. Felipe Urdaneta,
M.D. |
