The search for the perfect log book

20 Sep

OK so I haven’t found it yet just so you know. But I’m a little happier with my current set up at least.

Since starting back I’ve been trying to find a way to arrange and record my activity in the ED.

  1. Ultrasound: While I’ve been using it for ages, I’m not officially signed off through the college process. This is part due to a lack of people in departments I’ve worked in who are able to sign me off and part a lack of a good log book on my part
  2. Procedures: When I worked in NZ in my ICU job I kept a little note of all my tubes, lines, chest drains and LPs. I was at about 70 subclavians without a pop when I left. In changing phones back in 2007 I lost the txt file somewhere and so lose all the proof… I’m determined for that not to happen again, so that in 5 years time when I want to introduce mandatory fascia ilaica blocks for all fractured NOFs then I’ll have evidence to say I’ve been doing it for years
  3. Cases: this is a record of basic clinical details with anonymised images if available held privately and offline so that I can use them in teaching sessions and follow up on outcome.

Key to this is a tiny little notebook:

This helps me keep track of people on shift and helps me follow up. We have a decent (though far from perfect) computerised tracking system but it’s still on XP and isn’t exactly the most pleasant user experience.

When I get a bit of down time on shift (or more usually once my shift is finished…) I can get the images I need off the US machine or the PACS. Both systems allow easy anonymisation at source.

This what my ultrasound log book looks like:

Each US has a link to a folder of images which are all in gdoc format and so don’t use any of my google drive storage. GDrive allows vids and images all for free so you get the nice little 4 second of the SX view as well the stills of the RUQ. It looks like this when I click on the link.

Having files stored and organised like this will also make it pretty easy to add good stuff to GMEP.

The procedure log book looks like this:

This obviously takes a modicum of effort to remember and write things down, but I love being able to look back over what I’ve been doing and in particular what I’ve been learning.

One problem I do have is that the GDrive app on iOS is still a bit shit. I find it slow and the lack of offline editing (in an ED with poor mobile reception) makes life a tad difficult. That being said I still find the spreadsheet format invaluable over the likes of Evernote which I trialled and never really liked (heresy I know).

I use a lot of txt files and pdfs (like the PV cards) in work and I use dropbox (through goodreader of course) for all that.

Have your own thoughts or tips? Let us know in the comments.

18 Replies to “The search for the perfect log book

  1. Nice setup.
    One of the best things I ever did was start collecting interesting (and sometimes uninteresting) ECG’s, and then tag the files with my interpretations. I’ve got around 850 cases with 1500 some-odd tracings at the moment, and within seconds I can quickly pull out all of my STEMI’s, LVH’s, Wenkebachs, etc… for easy perusal. I hope to do the same with ultrasound in the future, but at the moment only have one saved case.
    Since most of us are constantly learning how to better use these tests, it’s nice to be able to look back on old cases and see subtle findings jump out that you were completely blind to the first time around. It’s also a bit sobering.

    • I tend to only collect the interesting ones and to be honest there aren’t that many of them. Tagging is great as it’s all very well having the image but it you can’t find it amongst 1500 you’re in trouble. The GMEP does it quite well in their system.

  2. Hi Andy,
    Your system of storage seems so much more sophisticated than mine….
    My US-scans are saved to hard-disk (from USB) & no mobile access. I’ll have to give Gdrive a go. Thanks!

    I have recently discovered Evernote & am in the process of importing my interesting ECGs, blood-gases and xrays into it (as it allows tagging and easy access at a later date). Heading towards the exams again, I have found that Evernote also allows me to create flash-card equivalents.

  3. i wouldn’t say i’m completely sold on my method as yet, but it’s the best i’ve found so far. I tried evernote but didn’t really like it though i admit the tagging feature is great.

  4. Surely there is someone out there in the FOAMed world that could put all of this together into an app. Between us we could spec the uber EM/PHEM logbook app, pref with some easy export option so we could print out for annual review / ARCP type stuff. Any budding app developers out there…?

  5. I had a go at setting up a database-log on my samsung galaxy via a 10 dollar app called handbase. I have tested it at home and it seems to work ok, though recording stills and videos will be a little cobbled on. Iphone has a database program called bento that might fit the bill. I wanted something that was quick for data entry, with lots of presets, i.e. Choose aaa or ptx (pneumothorax) from a popup list rather than type each time.

    Now let’s see if it’ll work…and I feel your pain for the loss of the log book/phone!

    JMB in Canada

  6. Pingback: Keeping an ultrasound logbook | Club Mona

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  8. Hi Andy,

    I was just googling logbooks and stumbled on this. Out of interest, what are you doing these days re keeping logs?

    Also, on the ‘cases’ bit of keeping a log, do you do this for every case? It’s recently been suggested to me. Penny for your thoughts? As always, thanks for the great website!

    • I still use a little book with stickies – as much as a help on shift as it is a way for me to log everything. I still use a google sheet for recording the number of procedures and ultrasounds.

      • Thanks for this. My current dept doesn’t have stickies in the ED(!). Do you ever have any issues/concerns re pt info? What info do you log; both for on shift and personal records? I’m leaning more to this simple notebook method (no internet at work, and google apps slower than paper on the shop floor)

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