Integrated Vital Medical Dynamics, LLC

Improving the lives of patients and those who care for them

Digital Intern Modules

Fluid management

  • uses your choice of metrics to determine the fluid volume status (Central Venous Pressure together with mean airway pressure, stroke volume variability, or extra-vascular lung water)
  • includes diuretics, dialysis, and adjustments for burns and congestive heart failure

Hemodynamic management

  • uses your physician set goal ranges for heart rate and mean arterial pressure and, optionally, Cardiac Output (or Cardiac Index) and Systemic Vascular Resistance (or Systemic Vascular Resistance Index)

Pulmonary/ Ventilation management

  • includes recommendations for all modes of ventilation and associated settings
  • includes adjunctive therapies such as nebulizers, intrapulmonary percussive ventilation, in-exsufflator, vest therapy, and inhaled medications

Blood Use Management

  • Hemoglobin management (red cell transfusions including options for OR)
  • Plasma and INR correction (including PCC and vitamin K when appropriate)
  • Platelet management
  • learn more here

Ventilator associated pneumonia prevention

  • Changing of suction tubing
  • HOB position
  • OGT placement
  • oral care package

Lactate management

  • Recommends lactate every two hours until result below target
  • Interfaces with fluids and cardiovascular modules to help bolster shock management (and sepsis as a subset)

Electrolyte management (calcium, potassium, phosphate, sodium, magnesium)

  • recommends corrective replacement or removal using various medications and routes of delivery
  • interfaces with fluids and ICP management modules

Rhabdomyolysis management

  • Recommends obtaining CK levels and runs diuretics, fluids, and if necessary dialysis
  • Interfaces with fluids and electrolyte modules

Foley catheter management

  • Recommends appropriately timed bladder scans and Foley catheter removal as well as when to straight cath patients
  • particularly useful with spinal cord injured patients

Pain and agitation management

  • Uses RASS, CPOT, and CNPI scores to attain goal level of sedation and pain control
  • Interfaces with ventilation, paralytic, and ICP modules

Secretion management

  • Useful for patients with copious oral secretions

GI bleed management

  • Interfaces with patient blood use management modules
  • Escalates and de-escalates PPI medications (oral and IV)

Enteric nutrition

  • Suggests appropriate tube feed formula based on labs and target nutrient levels including protein, carbohydrate, and fat
  • Interfaces with pulmonary, fluids, and electrolyte algorithms and is able to change direction based on new onset or recovery of organ system failure (particularly liver, renal, and pulmonary)

Hyperglycemia and hypoglycemia

  • Uses a patient’s current glucose level and their previous responses to insulin to adjust an insulin infusion appropriate for the patient’s individual insulin resistance

Hypothyroidism

  • Recommends oral and/ or IV replacement using levothyroxine
  • Interfaces with cardiovascular module

Adrenal insufficiency

  • Escalates and de-escalates hydrocortisone dosing given size and level of insufficiency
  • interfaces with fluids, electrolytes, and cariovascular modules to optimize care

Pentobarbital coma management

  • Adjusts bolus and infusion rate to optimize long-term use while preventing toxicity as much as possible
  • Uses EEG and multiple labs to address liver and bone marrow function
  • Interfaces with multiple modules particularly cardiovascular, blood product, fluid, and electrolyte modules

Seizure management

  • Manages pentobarbital coma for seizure control
  • future updates will help with choosing the best seizure medication and dose with adjustments for blood levels that are measured

Dysautonmia/ neurostorming management

  • evaluates heart rate, blood pressure, rigidity, pain, and agitation and doses medications to treat symptomatology accordingly

Intracranial pressure management

  • Takes control of sodium, sedation, pulmonary, and barbiturate coma algorithms as well as making other suggestions to help optimize ICP

Alcohol withdrawal

  • Uses gabapentin and atypical antipsychotic medications to help with control of withdrawal

Temperature management

  • Uses various methods and timings to help control temperature and considers renal and liver function for safety concerns.

In Development

Antimicrobial suite

  • hospital anti-biogram
  • anti-microbial stewardship
  • monte-carlo simulation antibiotic selection and dosing

Atrial and ventricular arrhythmias

  • Follow ACLS guidelines to treat arrhythmias

Total parenteral nutrition

  • Adjusts electrolytes, trace elements, fats, proteins, and carbohydrates to optimize needed nutrition support

Anti-coagulation

  • includes options for atrial fibrilation, heart valve, deep vein thrombosis/ venous thromboembolism and heparin-induced thrombocytopenia

Reversal of coagulopathy

  • Follows recommendations for all known coagulopathy reversal strategies, labs, and half lives not only of the reversal agents but of the process causing coagulopathy where present

Bowel and constipation management

  • Adjusts regimen to help with evacuation and optimization of bowel function

Digital Intern Distiller

  • Distills the various medical decisions accepted by the medical team into the various aspects of the systems based progress note for physicians and the SBAR note for nursing staff reducing most inpatient note writing by staff by an estimated 80%