Dictate the pre-operative assessment, the incident in theatre or the ward round note in critical care. Dictadoc transcribes on the computer in front of you, sends nothing over the internet, and can write doses, infusion rates and pressures in digits.
Pre-op clinic, theatre and critical care write at different speeds. Some need short notes one after another, others a long summary when the patient leaves.
The pre-operative assessment
History, medication and what to stop, allergies, airway assessment, the anaesthetic plan and what was discussed with the patient. Clinics run back to back, and a colleague often reads the note on the day of surgery.
The anaesthetic incident note
The anaesthetic chart fills up during the case. A difficult intubation, an allergic reaction or a block that did not work also needs an account in free text, written before the next patient goes to sleep.
The daily critical care note
Organ support, ventilation, haemodynamics, blood results and the goals for the day, patient by patient, between the morning ward round and handover. Nearly every line holds a value and its unit.
The critical care discharge summary
Days or weeks of admission summed up at step-down, for the receiving ward and for the GP. It takes the longest to write, and it gets done between admissions.
Day to day
What weighs down the writing in theatre and critical care
Doses and rates on every line
Today
A critical care note lists the noradrenaline rate, lactate, hourly urine output and ventilator settings. You type each value with its unit, standing at the bedside computer, and a typo in a rate only shows up when someone reads it back.
With Dictadoc
After you switch on "Numbers, units and dosages", dictate "eighty millilitres per hour" and Dictadoc writes "80 mL/h". Beats per minute and scores stay in words. Dictadoc calculates nothing and checks no dose: every value is yours to read.
Numbers, units and dosages
Dictating without leaving the clinical record
Today
In critical care the patient's record is open on the bedside computer. To dictate, you would have to switch to another app, find it among the windows, then come back. So the note gets typed in pieces, between calls.
With Dictadoc
Turn on a dictation key and pick the one you want. From the open record, a first press starts recording and brings up the floating panel, and a second one sends the dictation. If you also turn on text insertion, the note comes back into the record, at the cursor.
Dictation key
Text typed into the field
Notes that stay in the unit
Today
A critical care note holds the patient's history, their organ failures and sometimes a ceiling of care decision. A dictation sent to an online service leaves the hospital with all of that, and stops working when the network drops.
With Dictadoc
Dictating, transcribing and correcting all take place on the computer, and nothing leaves it. A network outage does not interrupt them. You need the internet once, for licence activation and a model download. By default, notes are kept in an encrypted database. On a computer the whole team uses, you can choose to erase everything when Dictadoc closes, either when you first open it or later from the settings.
Transcribed on your computer
Erased when you quit
Dictation example
A critical care note, dictated on the morning ward round
Critical care, day three of septic shock from a pneumonia.
What you say
day three of septic shock secondary to community-acquired pneumonia [full stop] intubated and ventilated [comma] sedated with propofol and alfentanil [full stop][new paragraph] noradrenaline being weaned [comma] mean arterial pressure above sixty-five millimetres of mercury [full stop] lactate down to one point six millimoles per litre [full stop] urine output eighty millilitres per hour [full stop][new paragraph] FiO2 forty percent with a PEEP of eight [full stop][new line] antibiotics narrowed to benzylpenicillin [open parenthesis] blood cultures grew Streptococcus pneumoniae [close parenthesis][full stop][new paragraph] plan to continue weaning noradrenaline and lighten sedation today [full stop]
What Dictadoc writes
Day three of septic shock secondary to community-acquired pneumonia. Intubated and ventilated, sedated with propofol and alfentanil.
Noradrenaline being weaned, mean arterial pressure above 65 mmHg. Lactate down to 1.6 mmol/L. Urine output 80 mL/h.
FiO2 40% with a PEEP of eight.
Antibiotics narrowed to benzylpenicillin (blood cultures grew Streptococcus pneumoniae).
Plan to continue weaning noradrenaline and lighten sedation today.
The words in brackets are commands. Dictadoc replaces them with punctuation and line breaks.
With the "Numbers, units and dosages" setting turned on.
The settings list every command for your language.
Privacy
What you dictate stays on your computer
Transcribed on your computer
Your computer transcribes your voice itself. Nothing you dictate is sent over the internet.
Erased on quit, if you want
Choose to keep nothing, and reports and recordings are erased when you quit Dictadoc.
Encrypted on your disk
The reports you keep stay in an encrypted database whose key is held by your system keychain.
For a clinic or hospital
Dictadoc Server transcribes for every workstation in your organisation, on a server on your premises. Nothing leaves your network.
Does Dictadoc know the names of anaesthetic drugs?
Not on its own. Its drug lists cover French dictation only, and anaesthetic drugs, used in hospital, are hardly on them. Add the ones you dictate to your vocabulary, written the way they must appear: propofol, sufentanil, rocuronium. Dictadoc then writes them that way in every report. It checks neither a name nor a dose.
Does Dictadoc calculate weight-based doses?
No. It is not a medical device, so it calculates nothing, checks no dose and flags no interaction. Values dictated with their unit are written in digits, "two milligrams per kilogram" becomes "2 mg/kg", and you read everything back.
Are heart rates and scores written in digits?
No, they stay in words, like degrees. "Numbers, units and dosages" converts a number only when a unit it knows comes after it: millimetres of mercury, milligrams, micrograms, millilitres, millimoles, percent, and simple rates such as milligrams per hour. Beats per minute are not on that list, and neither are the kilopascals of a blood gas.
Can I add to an incident account later?
Yes. Dictate the incident as soon as you have a moment, then add a take to the same report once the patient is in recovery. Each take keeps its recording: listen to it again before you copy the account into the record, and correct it by hand if a word was misheard.
Can a whole theatre suite or critical care unit dictate?
Yes, with one licence per computer, and a licence cannot move from one machine to another. When a lot of computers dictate, Dictadoc Server takes on the transcription for each of them, on a single computer in the hospital.
Install the app on Mac or Windows, buy a licence, then enter the key you receive by email in Dictadoc. The licence year starts on the day you activate it.
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