Snap Shot & Fluid Screens


Updates and Fixes


1. Please uninstall ACTc from your handheld. You do not need to delete the program from your application library in iTunes. Reinstall and synchronize the databases PRIOR to any use of ACTc to correct a database.

2. Error Fix: If ACTc is exiting prematurely, please re-install by deleting ACTc on your device and iTunes library. Then download the newest version and reinstall.

Quick Tip:

If you are in a limited wifi area and cannot connect to the internet, you can still use ACTc.


  1. Goto your iPhone/iTouch settings menu and disable your wifi
  2. Sign onto ACTc
  3. You are now able to use ACTc offline
  4. When you have internet service again, sign back on to take advantage of all of ACTc's features.

Want to Add a Drug?

You must fist sign into the Web Portal *

Remember that your email address on file is Case Sensitive

  1. Click on the "Add Drug" Feature
  2. Enter the data for the new medication
  3. Click Save
  4. Sign out
  5. Sync your handheld by going to "More ACTc" area
  6. Click on "ACTc Synchronize"
  7. Select Drugs to Sync your new additions
  8. They will appear in both the Snap Shot selection list as well as in the Drug Screen.
  9. Further modification can be done either on the iPhone/iTouch or via the web portal
  10. To delete a drug, Search for the drug via the Web Portal and select the delete link, then confirm (default drugs cannot be deleted)

Screen Shot 1

Screen Shot 2

Screen Shot 3

Organize Your Information

On this screen, users can organize their medication list, modify, or add medications that they commonly reference.


Note: that at the top of most screens in ACTc, you can change the Patient Type and weight (kg) - please click the "Update" button for changes to be accepted. Additionally, a "Notes Feature" has been added to allow you to take notes.

  • To add a drug from the database
    • Select the Plus sign “Add to drug list”
    • Scroll down and find the medication that is desired
    • Click “Add”
  • Changing Order
    • Click on Set up You will notice red “-“ sign to the left and 3 gray lines to the right of each medication
    • Hold down the 3 gray lines and move the drug to its new position and lift your finger
    • Click Done
  • Deleting a Drug from the screen
    • Click on Set up You will notice red “-“ sign to the left and 3 gray lines to the right of each medication
    • Click on the red “-“ and confirm the delete
    • Click Done
  • Deleting a Drug from the database
  • Adding Drugs
    • Scroll down and read the Left side bar
    • Note: the user must pay close attention that the units entered are consistent values (ie if using mg in one field, don’t use gm in another)
    • Remember to click save.
    • Sign out and Sync your handheld device (internet connect is required) to update your iPhone database


Based on your selection on the patient data screen, the fluid requirements are shown

  • Optionally, selecting HTN will also adjust the preoperative needs.
  • The individual totals are shown for an hourly total.
    • By selecting the “See Hourly Total”, the breakdown in fluid requirements is shown.
  • Clicking the "Notes" button allows you to add your own notes
    • If the fluid constants are changed or the wt is adjusted, please click the “Update” button to reflect those changes.
  • Fluid replacement is a very contentious topic. ACTc provides an example of comparing calculated fluid needs (including blood loss) compared to infused volumes using strictly balanced isotonic fluids and/or colloids not including blood.
    • In the Current Status, input your variables to compare them to the calculated total
    • Possible HCT is also shown based on the EBL inputted
    • In looking at different volume techniques
    • You can see the difference between pure crystalloid vs a mixed crystalloid and colloid technique
    • The user can further select the return ratio (either 1:3 or 1:1) to see what the required volume to meet the calculated needs

This feature is meant to stimulate thought and conversation about fluid replacement!

A Reminder

On each screen, ACTc has a “Help” button which explains in detail the research that establishes the calculation and thought flow of that specific screen. A complete list of references can be found in the About US section under “Readings” as well as some of our testers who took their valuable time to assist in ACTc’s development.

Legal Notice: ACTc is an educational tool that stresses many important aspects of the science of anesthesia. It accomplishes this by showing the multiplicities and connections of the daily calculations that every anesthesia provider uses for each case. Each calculation is further explained in detailed within each help section. Every effort has been made to ensure that the proper information has been provided to assist in the educational aspect of this program. Your use of ACTc releases its developers and Gasshead from any liability from ACTc use or misuse. ACTc is intended for education use only and is not intended to replace or dictate clinical decisions by trained anesthesia providers. Gasshead wishes the best of luck to all of its users