Mobile devices have become synonymous with not only our personal lives and downtime (wherever that can be found) but also our professional practice in the emergency environment. Given the ever changing and vastly variable case mix we face on a daily basis, having access to world class references right in your pocket has the potential to significantly enhance our care by complementing our gestalt and augmenting our experience in thoughtful and ergonomic ways. The following is a list of some of my favourite emergency applications you might find on my phone at any given moment:
ECI Emergency Procedures app (Free: web app – all platforms)
The NSW Emergency Care Institutes Emergency Procedures App is an amazing resource that was produced as a labour of love by a number of local emergency physicians. The application contains numerous practical, peer reviewed guides for common and not so common emergency procedures ranging from basic airway adjuncts right through to thoracotomies and craniotomies. While guidance on a number of these procedures varies region to region, this is one of the most useful learning resources I have found and it is yours for free. The app can be found at ECI Emergency Procedures App and can easily be saved to your phone homepage for rapid access.
While Pedistat costs a few dollars, it remains one of the strongest and easiest to use paediatric emergency references that can be found on the app store. Behind the simple interface you will find clear and current guidance on a wide variety of paediatric emergency topics ranging from equipment sizing, to drug dosage and common treatment protocols. While many organisations (my own included) have proprietary solutions for answering these questions, Pedistat is a great backup.
For those with access to the arrow EZ – IO intraosseous access device in their settings, the proprietary app by Teleflex is excellent. The app includes a number of references to guide the safe and effective use of the device including setup and site selection. Fortunately, much of the information is fairly general (such as site selection) and can be useful even if you use a separate style of IO insertion device.
Read by QxMD is a great resource for keeping up to date with evolving evidence, which can be a serious task in view of the vastness of emerging medical literature. Read allows you in input preferences relating to the things that matter to you before generally curating a list of articles that the app thinks you may find interesting. While it does still provide an abundance of papers to digest, I find the direction / filtering provided by the app to be really helpful when time is scarce.
For anyone using the Fisher & Paykel AIRVO2 high flow equipment, the proprietary app is a useful way to wrap your head around the interface before you line up in front of the patient. Essentially the app gives you a direct reflection of the control interface on an AIRVO to fiddle with at your leisure.
The ACI emergency eye manual is a tried and tested resource on eye emergencies that is approachable and easy to navigate with cards for common queries ranging from acute red eye to ocular trauma. There are a lot of really helpful graphics / photos in the app along with a useful paediatric section. A great eye reference for triage and beyond.
The Royal Children’s Hospital in Melbourne produce some truly amazing paediatric resources covering the whole spectrum from minor ailments to complex emergencies. There are two essential downloads for ED clinicians – the RCH clinical guidelines & the RCH emergency nurse practitioner app. Both of these apps serve as wonderful paediatric ED resources providing evidence-based practice recommendations across a variety of common ED presentations.
GoodSAM is an outstanding crowdsourcing service for CPR and first aid providers in the community. This app allows users with suitable qualifications (i.e. nursing / medical / paramedical registration etc) to register for notifications in the event that a person within a certain proximity to their current location requires emergency help. In many areas this app (or similar) is linked to the ambulance dispatch system allowing GoodSAM responders to be tasked alongside conventional EMS providers in the hope of rendering assistance to a patient more quickly. In addition to this primary function, the GoodSAM app also features an excellent defibrillator mapping option – a handy addition for any ED provider.
Even if you spend your days delivering care to critically ill patients, having an up to date first aid guide to hand can be more handy than you think. The Australian red cross first aid guide is a great free tool to fall back on in those minor crisis outside of your clinical comfort zone.
This is one of the most useful applications on my phone. The institute of trauma and injury management NSW trauma app has an enormous amount of useful and contextually relevant information for those working in New South Wales EDs, ranging from state-wide trauma treatment protocols, to topical lectures and even hospital specific logistic information – this application can even gives me a ballpark figure of how much blood is available for use in my hospital at any given moment. For those working outside of the NSW trauma context, this application is so jam packed with peer reviewed information it would be difficult not to find something useful inside. Naturally, keep an eye out for apps produced by any peak bodies servicing your local area of practice as the utility of having contextually relevant information in your pocket is truly game changing.
When dealing with traumatic injury and particularly orthopaedic trauma, the AO (Arbeitsgemeinschaft für Osteosynthesefragen) reference apps are indispensable resources for guiding the assessment, classification and management of a variety of common and not so common bony injuries.
Drug Infusion – IV Medications (Paid: apple)
While the drug infusions app may be appropriately replaced by a number of organisational resources at different sites, the app does provide a very useful calculator for titrating drug doses / volumes / rates on the fly. This is particularly helpful for saving time when dealing with vasopressors and alike which require careful titration with dosages that can be challenging to navigate.
For those working in the ambulance services producing these apps they serve as wonderful point of care references. For those working outside of the EMS setting, they still have plenty of excellent value. These applications provide services specific guidance for the management of a number of emergency situations – all laid out in a clear and systematic format. Each app has a number of additional bonuses including cardiac arrest calculators and protocol based checklists to streamline care in different scenarios.
Another essential resource for anyone caring for sick children in an emergency setting, regardless of the context. This resource allows for quick chapter by chapter navigation of the WHOs pocketbook of hospital care for children.
The visible body atlas is one of the best anatomy resources I have had the opportunity to use. There is a relatively significant cost of just under $40 attached to the app, but for this price you get an amazing experience breaking down every body system into its individual components for you to scroll and pinch your way around (and for context, this is still cheaper than almost all other anatomy textbooks I have owned in the past). Additionally, this app supports a number of useful graphics / animations that explain various physiological processes down to a cellular level. Money well spent.
Twitter / YouTube
These applications are recommended with a degree of caution. While social media can be an environment fraught with a unique set of challenges, there is massive potential in these platforms to serve as educational outlets. A great number of twitter and YouTube accounts exist with the primary goal of sharing useful clinical information. Always be judicious about the sources of information you choose but don’t dismiss the value of these great FOAM outlets. (Also note that YouTube is a great resource for paediatric distraction in a pinch).
Spotify (or similar music application)
Keeping yourself sane is very important. Don’t underestimate the value of having some tunes available for your down time (or as some background white noise in the medication room during those busy days).
In the same way as other social media approaches, podcasts can be endlessly helpful for keeping up to date with useful information or evidence during your non-productive time like your commute to work etc. There are tons of free podcasts out there along with paid options like EMRAP. Some of my favourites are below:
- St Emlyn’s
- EM Cases
- Resus Room Podcast
- Internet Book of Critical Care
- This Emergency Life
While electronic solutions for language translation are still not generally performing at a level that is considered suitable for everyday practice, there are times in the emergency setting where translation software may be a lifesaver in the short term. It is difficult to recommend one services over another (generally I use google translate for its simplicity), this is likely an area that will continue to grow and develop in the coming years. Possibly the best step towards a standardised approach for medicine in an Australian context is the CSIROs CALD assist app which can be found on the app store for free and provides some common cues that may help you through some universally applicable situations.
I feel very little needs to be said about this. Make sure your calculator app is within reach on the home screen – you will use this a lot.
Into the near future, the possibilities of smartphone integration in EM practice really are astonishing. Already there are hardware companies like the butterfly network making pocket sized ultrasound devices that link directly to your smartphone – making a large step towards democratizing the technology (aside from the still hefty pricing). In virtually every area of our practice there is likely some way to augment our effectiveness with the support of IT applications and other integrated technologies. In the near future I suspect augmented and virtual reality training software may be the next revolution in the emergency care / mobile device interface, and I am here for it.
These are just the apps that I use on a frequent enough basis for recommendation – if there are apps you use and love in the ED context I would love to hear about them.