SSAI2011: Detailed overview abstract presentations
All abstracts are presented in the format: 7-min oral presentation plus 3-min discussion. Site: Abstract presentation areas A and B (near Exhibition area, lower level and Entrance)
Wednesday June 15, 2011 Abstract session 1: Miscellaneous topics I Abstract area A: Chairs: Lars Rasmussen, Copenhagen, Denmark & Jan Henrik Rosland, Bergen, Norway Abstract 10:30-12:00 A new approach to interim analysis of a randomised clinical trial:The value Bartha E, Davidsson T, Brodtkorb TH, Kalman S (Stockholm, of further research on goal-directed haemodynamic therapy for elderly patients. Trial nr (NCT01141894 ClinicalTrials.gov) Efficacy and effectiveness of an algorithm used in a randomised clinical Fernlund ME, Bartha E, Imnell A, Arfwedson C, Andersson L, trial on goal-directed haemodynamic therapy for elderly patients. Trial nr (NCT01141894 ClinicalTrials.gov) Sleep disturbances after fast-track hip and knee arthroplasty Krenk L, Jennum P, Kehlet H (Copenhagen, Denmark)Why in hospital after fast-track hip and knee arthroplasty? Husted H, Lunn TH, Kristensen BB, Troelsen A, Gaarn-Larsen L, Kehlet H (Copenhagen, Denmark)Why in the Post Anaesthesia Care Unit after fast-track hip and knee Lunn TH, Kristensen BB, Husted H, Gaarn-Larsen L, Kehlet H arthroplasty? Orthostatic intolerance during early mobilization after fast-track hip Jans Øivind, Bundgaard-Nielsen Morten, Solgaard Søren, arthroplasty Johansson Pär I., Kehlet Henrik (Copenhagen, Denmark)Intraoperative transfusion threshold and tissue oxygenation - a Nielsen K, Johansson PI, Dahl B, Henneberg SW, Rasmussen LS randomized trial Partners' experiences of the post-discharge period after day surgery - a Majholm B, Esbensen BA, Thomsen T, Engbaek J, Moeller AM qualitative study. Abstract session 2: Obstetric anaesthesia I Abstract area A: Chairs: Seppo Alahuhta, Oulo, Finland & Kari Hreinsson, Reykjavik, Iceland Abstract 13:30-15:00 Ultra-Sound guided spinal anaesthesia for Caesarean Section- a Sprehn MS, Helbo Hansen SHH (Odense C, Denmark)consecutive, sono-anatomical study in 200 patients Is epidural analgesia during labour harmful for the child? Sandkvist Tornell Siv E, Karling Mats, Ekeus Cecilia, Högberg Ulf, Håkansson Stellan (Umeå, Sweden)Drugs used for intrathecal (IT) labour analgesia. Al-Kazwini Hadeel, Rosseland Leiv Arne (Skien, Norway)The use of Oxytocin in obstetrics in Sweden - time to change practice? Kjellqvist N, Kierkegaard A, Bålfors E (Stockholm, Sweden)Placenta percreta - a multidisciplinary challenge Albrechtsen C. K., Clausen C., Langhof-Roos J. (Copenhagen, Denmark)Remifentanil Target Controlled Infusion (TCI) used as rescue analgesia Schwarz GL, Bjørnestad E, Albrechtsen S, Volmanen P (Bergen, facilitating vaginal delivery in six high risk parturients. Case report: Acute Fatty Liver of Pregnancy accompanied by Diabetes Insipidus Post dural puncture headache in two similar-sized hospitals in Norway Haynes J, Hagen R (Stavanger, Norway)Trouble intrauterine hypoxia by his lung ventilation respiratory gas Urakov A.L., Urakova N.A., Kasatkin A.A., Gausnekht M.Y. through intrauterine aqualung Abstract session 3: Obstetric anaesthesia II + Miscellanous topics II Abstract area A: Chairs: Elin Bjørnestad, Bergen, Norway & Vicki Clark, Edinburg, Scotland Abstract 15:30-17:00 Venous air embolism during caesarian section: a case report and Aase T.Aa., Tvinnereim A, Spook-Fintl K, Sand S (Oslo, Norway)discussion Algorithm for postpartum neurologic complications Klemenzson GK (Reykjavik, Iceland)Hemodynamic effects of intravenous oxytocin during cesarean section Rabow S L, Olofsson P (Lund, Sweden)Timing of intravenous bolus may improve remifentanil patient controlled Volmanen P, Satomaa A-P, Alahuhta S (Savonlinna, Finland)analgesia (PCA) Perceptions of safety climate in anaesthesia and surgery Haugen AS, Søfteland E, Eide GE, Nortvedt MW, Harthug S (Bergen, Norway)Implementing WHO Surgical Safety Checklist at Akershus University Lüdemann Bente, Svaar Helge, Smith Jacobsen Lise, AHus Hospital (Ahus) Surgical Safety Checklist workgroup (Lørenskog, Norway)The occurrence of pneumonia diagnosis among neurosurgical patients: Kuusinen P, Ala-Kokko T, Jartti A, Ahvenjärvi L, Säynäjäkangas P, the definition matters Ohtonen P, Syrjälä H (Oulu, Finland)Local anaesthesia and remifentanil sedation for operative hysteroscopic Majholm B, Bartholdy J, Clausen HV, Virkus RA, Engbaek J, procedures in day surgery Way to prevent conjunctivitis after anesthesia and resusitation Rudnov V.A., Urakov A.L., Kasatkin A.A. (Izhevsk, Russian Federation)Thursday June 16, 2011 Abstract session 4: General anaesthesia I Abstract area A: Chairs: Ib Jammer, Bergen, Norway & Perti Pere, Helsinki, Finland Abstract 08:30-10:00 Abstract withdrawn Endotracheal intubation with Airtraq® versus Storz® videolaryngoscope Sørensen MK, Holm-Knudsen R (Copenhagen, Denmark)in children younger than two years - a randomized pilot-study Anaesthesia in a Patient with Morquio-Brailsford Syndrome. Malte Nielsen R, Pedersen NA, Skovgaard Olsen K (Copenhagen, Denmark)Rapid sequence induction and intubation with rocuronium-sugammadex Sørensen MK, Bretlau C, Gätke MR, Sørensen AM, Rasmussen LS versus succinylcholine – a randomized trial Response to Succinylcholine in Patients carrying the K-Variant in the Bretlau C, Soerensen MK, Rasmussen LS, Gätke MR Butyrylcholinesterase Gene Delirium after fast-track hip and knee arthroplasty Krenk L, Rasmussen LS, Bæk-Hansen T, Bogø S, Søballe K, Kehlet H (Copenhagen, Denmark)Central venous oxygen saturation (ScvO<sub>2</sub>), a useful guide to Østgaard G, Ulvik A, Jammer I (Bergen, Norway) fluid therapy ? Pholcodine withdrawal in 2007 has led to fewer reports of suspected de Pater GH, Florvaag E, Johansson SGO, Irgens Å, Guttormsen anaphylaxis during general anaestesia in Norway. Why does reversal of neuromuscular blockade increase BIS and Entropy Aho AJ, Kamata K, Yli-Hankala A, Lyytikäinen L-P, Kulkas A, Jäntti Abstract session 5: Abstract area B: Intensive care I Chairs: Jean-Daniel Chiche, Paris, France & Lars Marius Ytrebø, Tromsø, Norway Abstract 08:30-10.00 Is it safe to perform percutaneous dilatational tracheotomy in ICU patients Rosseland L.A., Laake J.H., Stubhaug A (Oslo, Norway) with increased bleeding risk or obesity? A prospective analysis of 1000 procedures. In situ systematic team training in the ICU with a high fidelity patient Meurling Lisbet, Hedman Leif, Sandahl Christer, Gustafsson simulator. An interventional study. Helena, Felländer-Tsai Li, Wallin Carl-Johan (Stockholm, Sweden)Regional differences in ICU resources and use in Norway Flaatten Hans, Dybwig Knut, Fonneland Inger-Lise, Kvåle Reidar, Laake Jon Henrik, Strand Kristian (Bergen, Norway)Association of a benchmarking programme on results of intensive care in Reinikainen M, Mussalo P, Hovilehto S, Uusaro A, Varpula T, Finland Ruokonen E, Pettilä V (Joensuu, Finland)Mortality of intensive care unit-treated cardiac arrest patients has Reinikainen M, Oksanen T, Leppänen P, Torppa T, Niskanen M, decreased in the era of therapeutic hypothermia Elderly patients in the ICU. Results from a retrospective analysis of three Flaatten H, Kaukonen M, Ruokonen E, Martner J, Nolin T, Kvaale national ICU registries Acute metformin overdose: Case report Novacek Martin, Zebrakova Tatana (Kolin, Czech Republic)Experience of treatment pregnant women with severe acute respiratory Kaminskiy V., Tkachenko R., Shlapak I., Khomenko O., Kaminskiy illness caused by influenza A(H1N1) in Kyiv. Abstract session 6: Emergency Medicine I Abstract area A: Chairs: Øivind Østeraas, Bergen, Norway & Hans Friberg, Sweden Abstract 10:30-12:00 A retrospective comparison of survival rates amongst in-hospital sudden Kuklin VN (Tromsø, Norway) cardiac arrest patients who were either treated or not-treated with opioids. A case of the Lazarus phenomenon with good outcome Kuklin VN, Scurr CF (Tromsø, Norway)In-hospital cardiac arrest - outcome before and after defibrillator Södersved Källestedt ML, Enlund M, Herlitz J (Västerås, Sweden)implementation and staff education: A population-based study from the National Registry of Cardiopulmonary Resuscitation in Sweden Chest compression decay during simulated advanced life support. Bjørshol C. A., Myklebust H., Assmus J., Søreide E., Sunde K. (Stavanger, Norway)Self-assessment of skills in prehospital ultrasonography Engaging a whole community in resuscitation Nielsen AM, Isbye DL, Lippert FK, Rasmussen LS (Copenhagen, Denmark)Quality and Consistency of Records from Pre-hospital and In-hospital Buanes EA, Heltne JK (Bergen, Norway)Resuscitation Delay in initiation of face mask ventilation (FMV) is associated with early Ersdal HLE, Mduma EM, Svensen ES, Perlman JMP (Stavanger, neonatal morbidity and mortality Abstract session 7: Education, miscellaneous topics III Abstract area B: Chairs: Doris Østergård, Copenhagen, Denmark & Per Christian Hyldmo, Arendal, Norway Abstract 10:30-12:00 Improving patient safety through blended learning : Training instructors Jacques T, Fraser K, Reece G (Sydney, Australia)for the DETECT programme How do medical students perceive team training in a simulated Escher C, Meurling L, Hjelmqvist H, Wallin CJ (Bromma, Sweden)environment? Medical simulation - Time to change old dogmas? Bredmose PP, Sollid S (Oslo, Norway)The Effect of a Difficult Airway Management Course on Anaesthesia Rewers M, Rosenstock C, Østergaard D (Herlev, Denmark)Residents´ Proficiency Checklists and competence cards are an effective educational tool for Svensson C, Toft P (Copenhagen, Denmark)senior consultants in anaesthesiology Residents´ knowledge of neuromuscular monitoring Gätke MR, Østergaard D (Herlev, Denmark)Optimal oxygen delivery Index (DO<sub>2</sub>I ) in elderly patients Arfwedson C, Bartha E, Imnell A, Fernlund ME, Andersson L, operated for proximal femoral fracture during routine anaesthesia? Cardiac surgery in octogenarians Hovdenes J, Fiane AE, Bugge JF, Espinoza A, Svennevig JL (Oslo, Norway)Fentanyl or remifentanil for fast-track in cardiac anaesthesia Khanykin B., Siddiqi R., Jensen P.F., Bigler D. (Copenhagen, Denmark)Abstract session 8: Intensive Care Medicine II Abstract area A: Chairs: Sten Walter, Sweden & Eldar Søreide, Stavanger, Norway Abstract 13:30-15:00 The Scandinavian Starch for Severe Sepsis / Septic Shock (6S) Trial: Haase N, Perner A, Wetterslev J, Åneman A, Guttormsen AB, Characteristics of included patients in the ongoing trial Tenhunen J, Klemenzson G, Scandinavian Critical Care Trials Group (SCCTG). (Copenhagen, Denmark)Comparison between two different CRRT machines, with regard to filter Bleeg R.C., Nyboe R., Andersen M.H., Schønemann N.K., Dreyer survival time Regional variation of organ donors in Swedish ICUs may indicate missed Nolin T, Walther S, Mårdh C, Karlström G, Möller C (Kristianstad, opportunities for donation. Impact of decreasing alcohol taxation on alcohol-related admissions to Tamminen J, Reinikainen M (Joensuu, Finland)intensive care Survey on sedation practices in Norwegian intensive care units Bekkevold M, Brattebø G, Kvåle R (Bergen, Norway)Necrotizing Fasciitis at Haukeland University Hospital, a review de Hoog B.J., Aardal S., Flaatten H. (Bergen, Norway)Severe soft tissue infection (necrotizing fasceiitis) treated according to a Jansen EC, Andersen JS (Copenhagen, Denmark) uniform protocol with optional hyperbaric oxygen How to exclude catheter-related phlebitis, thrombosis and embolism at Urakov A.L., Zabokrizhkiy N.A., Kasatkin A.A. (Izhevsk, Russian the administration of infusion fluids victim of terrorism and bio- technological disaster Abstract session 9: Experimental Abstract area B: Chairs: Else Tønnesen, Aarhus, Denmark & Jan Wernerman, Stockholm, Sweden Abstract 13:30-15:00 Resuscitation with adenosine, lidocaine and magnesium reduces fluid Granfeldt A., Hyldebrandt J. A., Nielsen T K, Sølling C., Dobson G. requirement and improves cardiac function following severe hemorrhagic P., Wogensen L., Vinten-Johansen J., Tønnesen E. (Aarhus C, shock Intravenous microdialysis, the impact of membrane lenght and dialysis Mattson Per, Rooyackers Olav, Wernerman Jan (Stockholm, pump velocity on accuracy Na<sup>+</sup>/HCO<sub>3</sub><sup>-</sup> cotransporter Cho Jun Hwi, Park Chan Woo, Won Moo Ho (Chuncheonsi, immunoreactivity changes in neurons and expresses in astrocytes in the gerbil hippocampal CA1 region after ischemia/reperfusion Real-Time Measurement of Myocardial CO<sub>2</sub> Tension Enables Pischke SE, Hyler S, Tronstad C, Holhjem L, Fosse E, Bergsland Quantification of Low Grade Myocardial Ischemia in the Course of J, Halvorsen PS, Skulstad H, Tønnessen TI (Oslo, Norway)Coronary Bypass Surgery Different phosphodiesterase 3A expression in the myocardium of newborn Hyldebrandt J.A., Schmidt M.R., Simonsen U., Ravn H.B. (Aarhus and 4-6 weeks old piglets. The effect of polyvalent immunoglobulin in experimental porcine sepsis Barratt-Due A., Thorgersen E.B., Sokolov A., Nielsen E.W., Castellheim A., Mollnes T.E. (Oslo, Norway)Bradykinin blockade ineffective in porcine sepsis Barratt-Due A., Johansen H.T., Reubsaet J.L., Seip K.F, Sokolov A., Tønnesen T.I., Mollnes T.E., Nielsen E.W. (Oslo, Norway)Effects of epinephrine on lactate, glucose, lipid and protein metabolism in Gjedsted Jakob, Buhl Mads, Nielsen Søren, Schmitz Ole, the placebo controlled bilaterally perfused human leg Vestergaard Esben, Tønnesen Else, Møller Niels (Aarhus N, Denmark)Reliability of HOMA-IR for evaluation of insulin resistance during Fujino H, Itoda S, Zen N, Yokoyama T (Fukuoka, Japan)perioperative period Abstract session 10: Regional anaesthesia Abstract area A: Chairs: Johan Lundberg, Lund, Sweden & Axel Sauter, Oslo, Norway Abstract 15.30-17.00 An increase in the efficacy and safety of peripheral nerve blocks for Valery Piacheski, Aliaksei Marochkov (Mogilev, Belarus)regional anaesthesia performed using ultrasonic visual guidance. The sciatic nerve block anesthesia by means of an anterior-medial Valery Piacherski, Aliaksei Marochkov (Mogilev, Belarus)approach. Abstract withdrawn Two Years`Experience and Results concerning Block Rooms (BR). Toft Peter, Filipovski Igor, Brock Marie (Horsens, Denmark)Impact of anesthesia method on hemodynamic changes during Gasiunaite Diana, Šipylaite Jurate, Kontrimaviciute Egle (Vilnius, laparoscopic colorectal surgery. Measurement of fluctuations in skin conductance for evaluating Kazansky JY, Kuklin VN, Mercer JB, Bjertnaes L (Tromsø, effectiveness of regional blockade Is is possible to avoid the insertion of a urinary bladder catheter during Ólafsson Dòrarinn, Karason Sigurbergur (Reykjavik, Iceland)Low Dose Spinal Anaesthesia (LDSA)? Assessment of spread of Transversus Abdominis Plane Block after Mitchell AU, Torup H, Hansen EG, Petersen PL, Mathiesen O, Dahl administration of 20 ml ropivacaine 0.5% bilaterally JB, Rosenberg J, Møller AM (Bagsvaerd, Denmark)Abstract session 11: Pain Abstract area B: Chairs: Lars Jørgen Rygh, Bergen, Norway & Leena Lindgren, Tampere, Finland Abstract 15.30-17.00 The pharmacokinetics, efficacy and safety of oxycodone in labour Kokki M, Gonzalez-Franco M, Raatikainen K, Ranta V-P, analgesia Sankilampi U, Neuvonen PJ, Heinonen S, Kokki H (Kuopio, Finland)Analgesic efficacy of oxycodone/naloxone is non-inferior to oxycodone in Kokki H, Kuusniemi K, Sjövall S, Huhtala J, Karjalainen P, Kokki M, postoperative pain management Intraoperative LIA for early analgesia after hip arthroplasty: A randomized, Lunn TH, Kristensen BB, Husted H, Solgaard S, Gaarn-Larsen L, double-blind, placebo-controlled trial in 120 patients Recovery after hip arthroplasty with preoperative high-dose Lunn TL, Kristensen BB, Andersen LØ, Husted H, Gaarn-Larsen L, methylprednisolone: A randomized, double-blind, placebo-controlled trial Genetic variability and sciatica Rygh LJ, Storesund A, Jacobsen L, Iordanova E, Gjerstad J (Bergen, Norway)Epidural pain management after major surgery: Female patients have Vigfusson Gisli, Sigurðsson Gisli, Breivik Harald (Reykjavik, better pain relief and need smaller amounts of analgetics than males Algoplus ®, an instrument for acute pain evaluation in the absence of Pickering ME, Bunna P, Pereira B, Rat P, Chit C, Madeline G, linguistic communication in doctor-patient exchange? a pilot study in Rejeaunier M, Dubost C, Serrie A (Clermont-ferrand, France)Cambodia. Treatment of patient with both hamstring tendinitis and piriformis Choi Sang Sik, Park Sang Hyun, Kim Yong Chul, Sim Sung Eun syndrome Friday June 17, 2011 Abstract session 12: Intensive Care Medicine III Abstract area A: Chairs: Richard Griffiths, Liverpool, UK & Reidar Kvåle, Bergen, Norway Abstract 08:30-10:00 Quality of life in ICU-patients after long-term ventilator therapy. Poukinski Andrei, Christensen Doris, Bestle Morten H. (Nykøbing, Denmark)Developing a generic simulation model for planning of critical care Steins K, Walther S M (Norrköping, Sweden)resource needs Remifentanil+propofol vs fentanyl+midazolam for sedation during Bjelland TW, Dale O, Kaisen K, Haugen BO, Lydersen S, Strand K, therapeutic hypothermia:a randomised controlled trial Therapeutic hypothermia reduces the elimination of morphine but not Bjelland TW, Klepstad P, Haugen BO, Nilsen T, Dale O midazolam in man Is open-ended intensive care the answer to prognostic difficulties? A case Robertsen A, Helset E, Laake JH, Nordby HK, Ellefsen KE, Wilson report of a 20 year old man in refractory status epileticus JA, Taubøll E, Sunde K (Oslo, Norway)Metabolic alkalosis is the most common acid-base disorder in ICU Mæhle Kjersti, Haug Bjørn, Flaaten Hans, W.Nielsen Erik (Bodø, patients. <em>Title: Management of young girl with hypoxia, avoiding positive Gawecka Ewa, Norum Hilde (Oslo, Norway)pressure ventilation.</em> Abstract: Management of acute respiratory failure complicating chronic thromboembolic pulmonary hypertension (CTEPH). Reliability of alarms of patient monitor in High Care Unit Kawakubo Y, Tanimoto C, Fujino H, Kobayashi M, Yokoyama T (Fukuoka, Japan)Abstract session 13: Intensive Care Medicine IV Abstract area A: Chairs: Anders Perner, Copenhagen, Denmark & Jon Henrik Laake, Oslo, Norway Abstract 10:30-12:00 Reduced costs of sedativa after implementation of a standardised Gundem TM, Helset E, Sporsem H, Terjesen AI, Sørensen K, sedation protocol for intensive care patients Influenza disease complicated with Hemophagocytic lymphohistocytosis Bentsen G, Aukrust P (Oslo, Norway) (HLH), a case report of a fatal case in a 10 year old boy. Anakinra (IL-1 receptor antagonist) for treatment of postiviral Nyrerød HCN, Aukrust PA (Oslo, Norway)inflammatory response in Influenza A H1N1 patients. Red blood cell transfusion during septic shock in the ICU Holst LB, Smith SH, Perner A (Copenhagen, Denmark)Changes in dextran 70 use and complication rates over time in ICU Nebelin L, Perner A (Copenhagen, Denmark)patients with septic shock Rejection of liver grafts is independent from the ischemia-reperfusion Haugaa H, Tønnessen TI (Oslo, Norway)Life threatening hyperammonemia after Asparaginase treatment Øverland G, Hausken J, Slåstad HS (Oslo, Norway)Abstract session 14: General anaesthesia II Abstract area A: Chairs: Sigga Kalman, Stockholm, Sweden & Mikko Pitkänen, Helsinki, Finland Abstract 08:30-10:00 Relationship between predicted plasma concentration of propofol and Solberg S, Kuklin V, Bjertnaes L (Tromsø, Norway)bispectral index during target control infusion Stunt-course in ultrasound assessment of gastric fluid. Filtvedt M, Ulvik A, Kuwelker M, Østgaard G, Gilja OH (Bergen, Norway)Genotyping of the butyrylcholinesterase gene is beneficial for selected Gätke MR, Kindberg K (Herlev, Denmark)patients Using impedance pneumography to estimate ventilatory changes during Seppä V.-P., Wojciech C., Harrison L. C. V., Hyttinen J., Yli-jet ventilation Integration of simulation-based learning in specialist training in Møller M.H., Østergaard D. (Holte, Denmark)anaesthesiology Comparison of tracheal intubation with a flexible fibreoptic endoscope Jepsen CEH, Rosenstock C, Gätge MR, Rewers M (Copenhagen, and the McGrath series five video laryngoscope in simulated difficult airway scenarios Glidescope improves laryngeal view Østerås Ø, Kuwelker MD, Heltne J-K, Søfteland E (Bergen, Norway)Intubation with the Glidescope®. Using intubation fibrescope as a Kristensen F, Søfteland E (Bergen, Norway)steerable stylet when it is difficult to insert the tube. Abstract session 15: Emergency medicine II Abstract area A: Chairs: Øyvind Thomassen, Bergen, Norway & TBA Abstract 10:30-12.00 A disaster in Denmark: The Mandø incident Hansen P M, Køhler D (Odense C, Denmark)In-hospital mortality pattern of severely injured children Do HQ, Steinmetz J, Rasmussen LS (Copenhagen, Denmark)Trauma system implementation: a hospital survey from southeastern Kristiansen TK, Ringdal KGR, Lossius HML (Oslo, Norway)Norwegian trauma team leaders – training and experience. A national Ringen AHR, Hjortdahl MH, Wisborg TW (Hasvik, Norway)point prevalence study A tale of two counties – comparison of fatal injury patterns in rural versus Bakke HK, Bakkane A, Hansen IS, Lilleng PK, Morild I, Wisborg T urban communities in Norway The lateral trauma position – what do we know, how do we use it? A cross- Fattah S, Ekås G R, Hyldmo PK, Wisborg T (Oslo, Norway) sectional survey of all Norwegian emergency medical services. Prehospital advanced airway management, reporting activities by the new Reid BO, Kruger AJ (Trondheim, Norway) Utstein template for airway management.
Patient name: __________________________________________________ 1. D/C home when awake, oriented and vital signs stable. 4. Provide Rx when patient goes home. These are located on the last page of Dr. Watson's Discharge Instruction form or on the chart. 5. Have patient and family READ and SIGN Dr. Watson's Discharge Instruction form and provide a copy for the permanent chart and provide the or
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