Informed EMS BLS-Intermediate APP

[rwik123]

Hey Guys.

Today I downloaded a very cool app onto my iphone. Its made my Informed which is a company who makes the classic flip handbooks for ems, nursing, and police. For a while now they've had an app, but it was basically a huge pdf of the physical handbook. Recently they came out with this new app which is a full fledged one, with menus and so on.

It seems very handy for me, being able to reference things quick or look to in an "oh :censored::censored::censored::censored:" scenario. The main menu has Airway, Cardiac, Medical Emergencies, Poisons, Trauma, Emergency medication, Common drug references, and a reference section.

The first part.. airway is ET Tube, King ect..basically just for the intermediate level, which is useless to me, but still cool to go over the diagrams and steps.

The cardiac menu has CPR step by step protocol, ECG placement, ACLS algorithms ect

Medical Emergencies has protocols for basically any encounterable scenario..all color coded to symptoms, contradictions and history

Poisons has around 20 types of poisons and the common side effects, interventions, cautions and brand names

Trauma has triage diagrams, and all the protocols for anything trauma along with some diagrams of bones

Emergency medications is an intermediate/BLS drugbook with contractions ect


One of my favorite features of the app is the calculators built in...APGAR, IV rates, Burn Scales, and Glasglow to name a few...along with the intermediate drug doses.

Another menu allows you to bookmark certain things that you want to jump straight to.

Below are some screen shots. For 5 dollars it seemed like a good price; the hard copy version costs about 20.

Enjoy!

 

[TransportJockey]

I have the ALS version loaded onto my HTC Hero. I like it. Never used it on a call yet, but when I'm bored there are times I'll boot it up and start reading random pages.

 

[ffemt8978]

I find these types of programs useful for self education and edification, but they are totally inappropriate for field use during a call. Here are my reasons why:

1) A conventional book/flip book is faster when you're looking for a particular item. If you're familiar with the the book, you can open it to approximately where the information you seek is.

2) A flip book does not require batteries.

3) A flip book is easier to decon. Do you really want to be whipping out your iPhone or Android while you're treating a patient and getting it contaminated with bodily fluids?

4) This last one is probably the most controversial, but I feel it is impolite to take out your phone and look something up in front of the patient (and the patient probably feels this way also). Patients understand when you pull out a medical reference book that you are looking something up to aid in treating their problem, but with a phone they don't know if you're looking something up, updating Facebook/Twitter, or reading your text messages.

 

[rwik123]

why'd this get moved to advertising? I was just assuming it was a review for either EMS talk or equipment

 

[rwik123]

I find these types of programs useful for self education and edification, but they are totally inappropriate for field use during a call. Here are my reasons why:

1) A conventional book/flip book is faster when you're looking for a particular item. If you're familiar with the the book, you can open it to approximately where the information you seek is.

2) A flip book does not require batteries.

3) A flip book is easier to decon. Do you really want to be whipping out your iPhone or Android while you're treating a patient and getting it contaminated with bodily fluids?

4) This last one is probably the most controversial, but I feel it is impolite to take out your phone and look something up in front of the patient (and the patient probably feels this way also). Patients understand when you pull out a medical reference book that you are looking something up to aid in treating their problem, but with a phone they don't know if you're looking something up, updating Facebook/Twitter, or reading your text messages.

The last point I agree with totally. I would feel like it would be awk/inappropriate to have your cell phone out in front of a patient. They will probably think your texting or something.

 

[TransportJockey]

The last point I agree with totally. I would feel like it would be awk/inappropriate to have your cell phone out in front of a patient. They will probably think your texting or something.

Most of the time... unless you're in a system like mine where we have to call the hospital on cell phones to give them report. My phone lives in an easy to get to pocket, and I do use it for drip cals and looking up things in Epocrates if I need to. In fact there have been times that a patient has asked me a question about their meds and I've shown them on the screen. But then again, even when I carried the flip book I don't think I ever used it in front of a pt.

 

[medicRob]

I can think of several apps I prefer over the informed field guides (Not really a fan of them)..

Anyways, my iPad and iPhone are stuffed with various medical textbooks and apps which I use daily. To name a few I use EMS Tracker, MedCalc, Paramedic Protocol Provider, Epocrates, ACID Plus, IV Drug Handbook, etc.

Tonight is actually a special night. I finally finished the EMS app that I have been working on as part of a contract deal between myself and a pretty good sized digital media marketing company after several months of work. All my code is in order, my storyboards are complete... all that is left now is for me to send the app to the marketing and review division, then it will move on to app store for the final accept/reject decision.

I have already started story boarding my next app which will be a Ventilator Simulator for iPad..

When my EMS app is approved by app store, I will be using funds from the development contract to outfit a local fleet of ambulances from a private company with the iPod touch preloaded with my app (which handles everything from logging of en route time, arrival time, etc.. as well as customizable service protocols, medical calculations, etc.) for a research study which I hope to submit to EMS World as an article on the utilization of iOS in prehospital medicine.


The moral? iOS and Android can be great assets to clinical practice if utilized properly.. iOS will find its way into more medical settings over the next few years.

Also, if it wasn't for angry birds, I would've gone crazy a long time ago.

 

[Aidey]

I have a couple of medical apps on my phone, if I need to use them I either step away or inform the relevant people clearly what I'm doing. "I'm going to look up xyz drug so we know what it is". Thus far no one has ever had a problem with it.

 

[JPINFV]

Most of the time... unless you're in a system like mine where we have to call the hospital on cell phones to give them report.

That's one of the very very few reasons why the person in the back should have their phone out. Even then, it should generally be prefaced with a quick, "I'm going to call the hospital to let them know we're coming, if you have any questions, feel free to ask..." just so they know that you aren't making a social call.


Unfortunately, unlike other health care fields, EMS can't just excuse themselves to go look in a reference source.

 

[rwik123]

I can think of several apps I prefer over the informed field guides (Not really a fan of them)..

Anyways, my iPad and iPhone are stuffed with various medical textbooks and apps which I use daily. To name a few I use EMS Tracker, MedCalc, Paramedic Protocol Provider, Epocrates, ACID Plus, IV Drug Handbook, etc.

Tonight is actually a special night. I finally finished the EMS app that I have been working on as part of a contract deal between myself and a pretty good sized digital media marketing company after several months of work. All my code is in order, my storyboards are complete... all that is left now is for me to send the app to the marketing and review division, then it will move on to app store for the final accept/reject decision.

I have already started story boarding my next app which will be a Ventilator Simulator for iPad..

When my EMS app is approved by app store, I will be using funds from the development contract to outfit a local fleet of ambulances from a private company with the iPod touch preloaded with my app (which handles everything from logging of en route time, arrival time, etc.. as well as customizable service protocols, medical calculations, etc.) for a research study which I hope to submit to EMS World as an article on the utilization of iOS in prehospital medicine.


The moral? iOS and Android can be great assets to clinical practice if utilized properly.. iOS will find its way into more medical settings over the next few years.

Also, if it wasn't for angry birds, I would've gone crazy a long time ago.

Keep us all updates on the progress of it. I'd love to check it out when it's done.

 

[Akulahawk]

I've had a few field guides over the years. I've very rarely had to whip one out in front of a patient. What I found most useful was for me to use them to review the expected type of call while en-route. That served as a reminder to ask certain questions that might only be pertinent on that particular call. I could survive (so to speak) without the guide, but they did help jog the memory at times.

I found it useful to tell my patient something along the lines of "Just a second, I need to look this up..." and proceed to still work with the patient while getting to that resource. When I've had to call my report in, I've always told my patients that I need to talk to the hospital and it's OK to interrupt me if you need something. I'm actually a fan of the phone-in reports. You get to talk more personally with the MICN and give a more complete report as you're not constrained by the transmit timer or the knowledge that someone else is listening to your report and needs to give theirs right after you do... You can also develop a better "feel" for what that particular MICN wants by the tone of their voice...

 

[Hockey]

Does anyone know if it has like Dopamine calculations etc for the advanced?

 

[medicRob]

Does anyone know if it has like Dopamine calculations etc for the advanced?

Use MedCalc, it has hundreds of medical calculations

Formulas, scores and classifications include (not exhaustive):
• A-a O2 Gradient and Ratio
• ABCD2 Score
• Abbreviated Mental Test
• Absolute Neutrophil Count
• ADO Index
• Age
• Allowable Blood Loss
• Alvarado Score
• Anion Gap (serum,urine)
• APACHE II Score
• Aphasia Classification
• APGAR Score
• ASA Classification
• Basal Energy Expenditure
• Bicarbonate Deficit
• Bishop Score
• Blatchford Score
• BODE Index
• Body Mass Index
• Body Surface Area
• Burn Area
• Canadian C-Spine Rule
• Canadian CT Head Rule
• CAP PIRO Score
• Cardiac Output (echo)
• Cardiac Output (Fick)
• Cardiac Valve Area (Gorlin)
• CHADS2 Score
• Change In Serum Na
• Child-Pugh Classification
• Clin. Pulm. Infection Score
• Cormack Classification
• Corrected Ca (Albumin, Protein)
• Corr. Phenytoin (Albumin)
• Corrected Na (glucose, lipids, protein)
• Corticosteroids Equivalence
• CURB-65 Score
• CVC Optimal Positioning
• DAS28 (ESR and CRP)
• Delta Gap and Ratio
• Delta PP
• Dermatome Map
• Dose Calculator
• Epworth Sleepiness Scale
• EuroSCORE
• Eye Chart (Snellen)
• Expected PCO2 (Winters)
• Fisher Scale
• Fluid Repl. For Burns
• FOUR Score
• Fractional Excretion of Ca, Na and Urea
• Framingham Gen. CV Risk
• Geneva Score for PE
• GFR (Cockroft-Gault)
• GFR (Creatinine measured)
• GFR (CKD-EPI)
• GFR (MDRD)
• GFR (Salazar)
• GFR (Schwartz)
• Glasgow EtOH Hep. Score
• Glasgow Coma Scale
• Glasgow Coma Scale (ped)
• Glasgow Outcome Scale
• Glasgow Scoring System
• Growth Velocity
• Harvey Bradshaw Index
• Heart Rate (EKG)
• Henderson-Hasselbalch
• Hepatitis Disc. Function
• Hunt Hess Scale
• Ideal Body Weight
• In-Flight PaO2
• Infusion Management
• Infusion: IV Drip Rate
• Infusion: Rule of six
• Injury Severity Score
• Interval Calculator
• Iron Deficit
• Karnofsky Scale
• Kt/V (URR)
• LDL Cholesterol
• Light's Criteria
• Likelihood Ratios
• Liver Volume
• Lung Age
• Maintenance Fluid (children)
• Mallampati Classification
• Mean Arterial Pressure
• MEES
• MELD (-Na) Score
• Microalbuminuria
• NAC Dosage Regimen
• NACA Scale
• NIHSS
• Number Needed To Treat
• NYHA Functional Class.
• Odds - Probability Conv.
• Opioids Equivalence
• Osmotic Gap (serum)
• Osmotic Gap (stool)
• Oxygen Index
• O2 Tank Remaining Time
• O2 Transport Parameters
• Pain Visual Scale
• PaO2 / FiO2 Ratio
• Pediatric Trauma Score
• Pediatric Tube Size
• PELD Score
• PERC
• Plasma Volume
• Pneumonia Severity Index
• Post-test Probability
• Pred. Body Weight (ARDS)
• Pred. Peak Flow (adults)
• Pregnancy Wheel
and many more...

 

[C.T.E.M.R.]

do they have any apps like this on the android market? If so id love to use them on my tablet for educational purposes.

 

[Hockey]

CTEMR they do have this for the Android market as well. ALS and BLS/Int

 

[Lady_EMT]

I love apps like this for informational purposes, but I find it extremely rude to pull out a phone infront of a patient. Especially being young (I'm 19), if I were to pull out my phone to look up a med app, I'm sure my pt would assume I was checking up on my Facebook.

We have the actual hard copy of that booklet right in the back of the rig if anyone really needs it.

I'm not downing any of those apps though, I find them very interesting.

 

[medicRob]

I love apps like this for informational purposes, but I find it extremely rude to pull out a phone infront of a patient. Especially being young (I'm 19), if I were to pull out my phone to look up a med app, I'm sure my pt would assume I was checking up on my Facebook.

We have the actual hard copy of that booklet right in the back of the rig if anyone really needs it.

I'm not downing any of those apps though, I find them very interesting.

Here is the solution, involve them in what you are doing. There is no reason why you shouldn't be able to show them the screen as you are plugging in your numbers and doing your searches. Take a moment while you are doing that to explain to them what you are doing.

For instance, if I wanted to calculate a drip rate without pen and paper, I would pull out my iPhone and say something along the lines of,

"Sir, I am going to use a special medical calculator that will help me precisely calculate your drip rate, see?" *turns phone where they can see*

This will usually strike up a convo about technology and will give your patient something to think about other than their injury.

Now, if I am just sitting there entering numbers when the patient can see the screen, they will probably think I am texting.

Before iPhone, it was quite common for me to use calculators in any unit I work on. I would have my EMT get a manual pressure (I always want a manual pressure as my starting point, you should too), then as he read out the pressure, between interventions, I would calculate the MAP ([pSystolic + 2(pDiastolic)] / 3) which is a fantastic inicator of a patient's perfusion. Anyways, I would routinely use my calculator in various situations such as dosage calc and the Parkland Burn Formula to name a few.

Since my switch over to iOS a few years ago, I have found apps that save me several steps by doing the calculations directly allowing me to plug in the various x's and y's. Moreover, instead of spending my time trying to remember the Brund and Lowder chart, I have it right there and can simply click on the little illustration of the body the areas that are burnt and it will auto calculate the total burnt surface area multiply it by 4 and then multiply that by the pt weight in kg once I have entered it and will output not only the 24 hour volume, but the first 8 hour volume, etc.

The key point is, apps (when used correctly) can be quite efficient in clinical practice and can save you time. The patient should have no problem with it as long as they are aware that you are plugging in pertinent medical values with clinical applications as opposed to just texting your friends.