Excursions, monitoring gaps, airway events and the PACU course from an anesthesia record, for attorneys and legal nurse consultants.
Paste the anesthesia documentation: the pre-anesthesia evaluation, the intra-operative record or electronic vitals log, the medication log, airway and handoff notes and the PACU record (up to 50,000 characters). The analyzer builds the case card (procedure, ASA class, airway assessment, anesthesia type, providers), a timed event list, and a table of vital-sign excursions (hypotension, hypoxia, hypercarbia, bradycardia, hypothermia and others) with the values documented, the threshold applied, the duration computed from the times as written, and whether a response is documented. It lists every medication with dose and route, every airway event, each stretch of the record with no vital-sign entry, every handoff, the PACU arrival, score, events and discharge, and the flags and record gaps a reviewer would chase. When the record states its own alarm limits or targets, those are used; otherwise a labelled typical adult threshold is applied and marked for verification. It does not judge the anesthetic; it shows what the record says and what it leaves out.
The record was long and the analysis stopped before the end. Paste the later phase (intra-op second half, PACU) as a separate run.
Summary
Case
Vital-sign excursions
Monitoring gaps
Medications
Airway events
Handoffs
PACU
Flags
Timeline
Gaps in the record
How to use the result
Check the threshold on every excursion row. Rows marked "typical adult threshold, verify" were not judged against this record's own limits. The anesthesia machine and monitor alarm settings, the pre-induction baseline and any stated MAP target are what an expert will use; request the device data to get them.
Duration comes from the charted times, not from the device. Electronic anesthesia records sample every 15 seconds to 1 minute but may chart every 5; hand-written records are often back-filled. The device export with raw data is the only source that shows how long an excursion actually lasted.
A monitoring gap is a records request first. Missing entries may be an export artifact, a transport interval or a true gap. The electronic record's audit log and the monitor's own trend memory resolve it.
Airway events need the whole sequence. Number of attempts, grade of view, device changes, the lowest SpO2 during laryngoscopy and the EtCO2 confirmation are each a separate fact to pin to a quote before an expert sees them.
Handoffs with no documented content are a question for the relieving provider, not a conclusion about what was said.
Verify every quote against the page it came from before it goes into a chronology, demand letter or expert packet.
What to request next
Electronic anesthesia record export with the raw device data stream (every sampled vital, not the charted summary) and the audit log of entries, edits and time stamps
Infusion pump logs (propofol, remifentanil, vasopressor and other drips) with programmed rates, boluses and alarms
Capnography, ventilator and anesthesia-machine trends (EtCO2, FiO2, tidal volume, peak pressure, agent concentration) and machine alarm history
Pre-anesthesia clinic notes, the airway assessment form, prior anesthesia records and any difficult-airway letter or registry entry
PACU flowsheet with every vital-sign set, scores (Aldrete / PADSS), nursing notes and discharge criteria
Pharmacy dispensing records, the automated dispensing cabinet log and the controlled-substance / wastage log for the case
Surgeon's operative note, circulating-nurse intra-op record and the sponge / position / timeout documentation, to cross-check times
Code sheet, rapid-response record or incident report if any event occurred, and the department's own quality or peer-review referral to the extent discoverable
Provider schedule and relief log showing who was in the room at each time, and the supervising anesthesiologist's concurrent cases
The institution's anesthesia monitoring and handoff policies in force on the date of service
Need this across the whole record?
MedLegal AI's Records Analyzer and Timeline Builder read the complete chart (pre-op, operative, anesthesia, PACU and inpatient, thousands of pages), pin every finding to a Bates page and build the chronology for the demand or expert packet. Free account to start.