22.11.1. Drug Chart / Protocol Setup

Drug Chart Setup

Your clinician will need to establish the protocols and drug doses used for standard and non-standard anesthetic procedures.
To get started, go to Settings > Patient Flow Setup > *Drug Chart/Protocol Setup *

You will need:
1. Your clinic’s protocols.
2. Current drug charts.
3. Formula for dosing.

The chart setup should be your standard dosing based on species and maturity. The charts cannot be restricted to sex. Any deviations from one standard dosing would be set up as a non-standard protocol. These would be for cases where your clinic uses different dosing for animals such as aggressive, male vs. female, brachycephalic, etc.

If you follow the ASNA drug protocol, we have that available HERE.

Dog Protocols

1. Go to Settings. Click Patient Flow Setup in the left-hand menu.
2. You will see options for drug charting and managing controlled substances. To set up our drug log, we use the ASPCA spay/neuter drug charts, which can be found on their website. It is the chart displayed below.
   
   ASPCA drug chart
3. Next, click on Settings > Patient Flow Setup > Drug Charts/Protocol Setup > Dog Protocol (under Standard Protocols, which are used the majority of the time).
   
   Updating standard drug protocols
4. This is broken into Pre-Med, Induction, Post-Op, and Other. Click Create a New Drug Chart on the right of Pre-Med Drug Protocols.
   
   Creating a new drug chart
5. Each Drug will have the concentration for every weight range in the ASPCA drug chart. As you can see, Acepromazine has two separate bottles (concentrations), which will require two columns in Patient Flow. To clarify, the different bottles have different concentrations and need to be entered separately, as you cannot just draw a different amount for different weights from the same bottle.
   
   Drug concentrations based on weight
6. Select the medication you would like to create in Patient Flow. Fill out the required information for the drug, and add a weight range.
   
   Adding a new drug to a protocol
   
   
   Generate Drug Dosage

*Note: Establish whether your clinic measures weight in kgs or lbs. You will put this in Clinic Profile > Preferences > check use kilograms instead of pounds if that is the case.

7. Select the route by which the drug is given (SQ or IM, SQ, IM, IV, other).
8. Select yes or no depending on whether the drug is given the morning after while the animal is still in your care. For some, this is not relevant.
9. Choose a color for your chart. This is up to you.
10. Add in the weight range found in the drug chart.
11. Add the dosage based on weight.
12. Decide to round to 1 or 2 decimal places. To decide, you can look at the ASPCA chart.
13. Click create draft drug chart, and double-check the values. If the values are correct, save the chart at the bottom of the page.
14. Repeat these steps for each dose/weight range.

*note: If your protocols deviate from the formula, change the values in the draft chart manually.

15. You can go to Clients > Patient Flow to view the columns created.

*Note: if there’s a discrepancy between what you generate and what is in the drug chart, make sure to do the math yourself and ask your veterinarian what’s preferred.

move through these steps with each category of drug, entering the individual drugs in the order they are drawn

16. For drugs that don’t have separate bottles for different doses, you will click add weight range in the top right corner after entering the first weight range.
    
    Adding a new weight range for a drug
17. For drugs like Meloxicam, where the dosing is age-based. You will select “adult” or “pediatric.” The weight range will include any weight.

*Note: inputting the drugs in the order they’re drawn puts them on the same page in patient flow, so you can see them all at once.

Cat Protocols

1. Go to Settings > Patient Flow Setup > Cat Protocol
2. Select the drugs that apply to your clinic and complete with the same steps as dog protocols.

*Note: if your dosing is the same for different ages, you do not need to select adult or pediatric.

Non-Standard Protocols

1. Go to Settings > Patient Flow Setup > Drug Charts/ Protocol Setup > Click Add a Protocol and type the name of the protocol as well as the species it is for.
2. To save time on the information, you can go up top to Copy From Standard Protocol and change only the drugs that will be different. Give this process about 45 seconds.
   
   Creating a new protocol by copying an existing one
3. In the Drug Log, when you click on the animal’s drugs button rather than selecting given, which would input the standard protocol, you can select the non-standard protocol that is relevant.