Therapeutic Organizer (TH.OR.): A New Tool in Critical Patient Management Roberto Antonicelli, 1 Moreno Cecconi, 2 Nino Ciampani, 2 Massimo Valente, 3 Andrea Penna, 4 Corrado Marri, 4 Rosaria Gesuita, 5 and Enrico Paciaroni 1 1 Department of Cardiology, I.N.R.C.A. (Italian National Research Centre on Aging), Ancona; 2 Division of Cardiology, “Lancisi” Hospital, Ancona; 3 Department of Intensive Care, Ancona University, Ancona; 4 ISELQUI Technology Ind., Ancona; 5 Centro di Epidemiologia e Biostatistica, Ancona University, Ancona, Italy Key Words. CCU, cardiovascular therapy, microcomputer, palmtop computer Many drugs used in intensive care, and particularly in cardiology, are characterized by a narrow therapeu- tic index and dose-related effects, hence the need to calculate the doses with great accuracy. Furthermore, drugs used in the emergency room (ER) are usually administer intravenously using special devices that ensure optimal infusion. Doses and infusion rates must therefore be calculated considering the infusion instruments available in the particular Cardiac Care Unit (CCU) or ER, and the speci~c volume of dilution needed. It must be also emphasized that in the emergency setting, such calculation must be per- formed quickly. A further consideration is the profes- sional experience of the medical staff working in in- tensive care. As a general rule, some of them work mainly in this unit, and are therefore highly skilled and familiar with these drugs. However, coverage of shifts in an intensive care unit implies a high turnover of staff who are not always engaged in this type of work but who may be cardiologists (fellows, residents, etc.) with less speci~c experience and, above all, less practice in rapid, accurate delivery of pharmacological treatment. A ~nal consideration concerns General Emergency wards, where it is sometimes necessary to use drugs typically employed in the CCU, with staff often unfamiliar with the doses required for optimal effects. The Therapeutic Organizer (TH.OR.) has been de- signed to provide a practical answer to all these dif~culties. It is a small palmtop computer designed as an aid in solving most of the problems arising from the use of drugs in intensive cardiac care. The Therapeutic Organizer The Therapeutic Organizer is a small palmtop com- puter (Figure 1) with a hardware structure based on an Intel microcontroller with _exible architecture. It can host a protected memory box with a preloaded operat- ing system to manage particular medical specialites (in this case, cardiology). On the basis of the data entered, the computer calculates a result consisting of medical information concerning the optimal dosage of the drugs selected, diagnosis, etc. Once switched on, the TH.OR displays menus, one after another, via which data are entered. Except where numbers have to be keyed in, the menus dis- played all scroll the information. The ~rst menu dis- played is to input the working environment, that is, therapy or acid–base balance. Selection of one environ- ment or the other produces an ordered series of spe- cialist menus for that particular environment. After data entry, the display automatically gives the results of calculation. For scroll menus with a particularly large number of items, the data search is speeded up by selectively calling up similar groups of items alpha- betically. Because reliable results are essential, each time the organizer is switched on a fast automatic diagnostic routine is run, including tests on the most critical elec- tronic parts. The computer operating system, in addi- tion to providing a particularly simple operator inter- face, has a series of internal controls and constraints to prevent the user from following paths or entering situ- ations that are incompatible with correct use of the TH.OR. Speci~c checks on the consistency of the data input are performed for each menu and are directly Address for correspondence: Dott. Roberto Antonicelli, Diparti- mento di Cardiologia, Istituto I.N.R.C.A., Via Della Montagnola, 164, 60100 Ancona Italy 173 Cardiovascular Drugs and Therapy 1999;13:173–176 © Kluwer Academic Publishers. Boston. Printed in U.S.A.