Anesthesia
A live monitoring worksheet for a procedure: vitals ticks, drugs, and events, signed and locked when the patient is recovered.
On this page
Anesthesia isn't part of the SOAP note. It's its own record, reachable from the Anesthesia tab on the Surgery page. A record can optionally reference a visit or a hospitalization stay, but neither is required, so you can start one for a standalone procedure too.
Anesthesia records don't feed into visit finalization. Signing this record locks the anesthesia worksheet; it doesn't sign the patient's SOAP note, and finalizing the visit doesn't touch this record either. Keep both in mind if a patient had a procedure during a visit.
Starting a record
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Open Surgery → Anesthesia and click New record
In the Start anesthesia record dialog, paste the patient's ID, name the procedure (e.g. "OVH," "dental scaling," "mass removal"), and set the ASA status (I to V, or E; it defaults to II).
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Fill in the anesthesia plan
Enter ET tube size, premedication, induction agent, and maintenance agent (defaults to Isoflurane), IV catheter details, and whether the patient is intubated (defaults on).
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Click Start record
You're taken straight to the live worksheet, and the record status is
in_progress.
The current version needs the patient's UUID rather than a name search. The dialog itself flags this as a v1 limitation, with a proper patient picker planned alongside surgery scheduling. Copy the ID from the patient's record URL or profile if you don't have it handy.
Working the worksheet
The worksheet runs a 5-minute tick timer, a countdown ("Next tick in m:ss") that turns amber when a tick is due. At each tick, log HR, RR, SpO₂, EtCO₂, temperature, blood pressure, gas agent and percentage, O₂ flow, and fluid rate, then click Log tick now. You can also Pause the timer, or log an off-cycle entry at any point outside the regular cadence, including a "Dictate vitals" AI-fill option to speak readings instead of typing them.
Use Log event for anything that isn't a scheduled vitals tick: a drug bolus, a clinical event (intubation, extubation, a position change), or a free-text note. Drug entries use a searchable drug-reference lookup rather than free typing. Chartling needs to resolve the exact drug to check its DEA schedule, so the Log button stays disabled until you pick a match from the list.
Anyone viewing the worksheet sees new entries within about 15 seconds without refreshing, so a second staff member watching the same procedure stays current.
Controlled drugs during anesthesia
Selecting a controlled drug for a bolus shows an inline warning ("Schedule … controlled substance: witness permission required") and requires the rx.controlled.witness permission to submit, in addition to the general vitals.write permission needed to log anything on the worksheet. Every drug bolus (controlled or not) writes a DEA-flavored audit entry recording drug, dose, and route.
The standard controlled-substance flow requires a dispenser (rx.controlled.dispense) and a separate witness (rx.controlled.witness) held by two different staff members. Logging a controlled-drug bolus on the anesthesia worksheet currently only checks that the logging user holds rx.controlled.witness. It doesn't require a second person to countersign the entry the way pharmacy dispensing does. If your clinic's controlled-substance procedure assumes a two-person check on every controlled administration, enforce that as a manual practice for anesthesia boluses until the worksheet has its own witness step.
Ending and signing
When the procedure is done, click End recording. This sets the record to completed and stops the tick timer. When you're ready to close it out for good, click Sign and confirm. Signing sets the record to signed, stamps who signed it and when, and locks it. No more ticks, events, or edits. If you click Sign without having clicked End recording first, Chartling ends the recording for you automatically as part of signing.
You can also Cancel record if the procedure didn't go ahead. Cancelled records are locked the same way signed ones are.
Unlike a SOAP note, which supports a formal amend/addendum flow after signing, a signed or cancelled anesthesia record has no built-in unlock or correction path. Double-check the worksheet before you sign. If something needs fixing afterward, note the correction elsewhere (e.g. the visit record) rather than expecting to reopen this one.
FAQ
Nothing currently blocks signing a record with an empty (or sparse) tick history. Chartling doesn't require a minimum number of entries. Treat regular ticks as a team discipline, not a system-enforced requirement.
Not yet. There's a placeholder for this in the data model, but no export is currently wired up in the product. For now, use the on-screen worksheet or your practice's existing paper/PDF anesthesia sheet if you need a printable record.
No. You can optionally link a record to a visit or an inpatient hospitalization stay, but neither is required. A record can stand entirely on its own.
No. The worksheet doesn't flag abnormal readings automatically. The amber tick-due countdown just means a reading is due, not that anything is wrong. Continue to rely on your team's own monitoring judgment.