Apps in the Line of Duty

Before I get into the meat of the article, I thought I would take a moment to introduce myself. My name is Nathan and I have been a Mac user since the Apple ][ days. Besides blogging about the iPhone and reviewing apps for the great guys at WhatsoniPhone.com, I also work as a paramedic for a Southern California ambulance company. Today I thought I would highlight some of the ways the iPhone has enhanced and assisted my work as a paramedic.

I knew the moment I saw the iPhone back in 2006 that it had the potential to become a valuable tool for the medical field at large, particularly my work in the prehospital setting. Computers are already a large part of our daily workflow, and as mobile computers become more common we see them being used more and more as tools in the medical field. Today we will look at six apps that assist in the various aspects of my work in the field, and back at station.

Safari – Built in
Before third party apps were even announced the fact that the iPhone brought the Internet to your hand in such a functional way opened up a lot of possibilities. The Internet is a valuable research tool with a wealth of knowledge on medical conditions and procedures. I am constantly expanding my knowledge of not only my field of emergency medicine, but also in the hospital setting at large so I can know what to expect for treatment of my patients when we arrive at the emergency room. Having the Internet at my hands allows me to follow many great EMS related blogs by individuals that are shaping and challenging the EMS industry. Web based RSS reader apps like Google Reader have been a useful tool for tracking site updates before apps like netnewswire and others were ever written for the iPhone. Even today I use Google Reader to keep up to date on the latest medical news and discussions.

Google Maps – Built in
While using the browser to assist me in my work may be obvious, one app that most would overlook has been available on the iPhone from day one, and has served as one of the most valuable tools. That app is Google Maps. Trust me when I say that we have no lack of mapping tools on our ambulances to help us reach a call as quickly as possible. We have quick reference books that show a few blocks at a time as well as traditional map books for looking up streets from larger view. All of these tools are good at what they do, and are good to fall back on when a technological solution fail, but I have found that for most circumstances google maps excels in giving a dynamic view of our call location. I am able to view the location from multiple zoom levels as well as scroll around when we must detour around a normal route and take roads less traveled. Google maps also shows actual property lines which can make locating houses at night much easier. If time permits, street view can even give us an actual view of the building we are looking for, as well as the neighborhood we are entering. I would never throw out my map books, but when time matters I grab my iPhone to quickly locate our call location.

Epocrates – iTunes Link
Once Apple announced the App Store, the floodgates of possibilities opened. One very early contender that was even at the announcement keynote was Epocrates. This app is a must have for anyone in the medical field of any level. At its most basic, Epocrates is a drug reference guide that is constantly being updated with new medications. The guide gives all the important information about a drug including indications (what the drug is given for), contraindications (when a drug should not be given), side effects, and even the pharmacology of the medication. There are so many medications being used today that it is almost impossible to learn all of them. Being able to quickly look up a medication and see critical information can help shed light on a patient’s medical situation. This becomes particularly helpful when dealing with patients that don’t know why they take their medication. Epocrates also has images of pills to help with identification. One tool in epocrates that has been an invaluable tool is the pill finder. This allows the user to put in the description of a pill, and to find out what medication it is based on its size, shape, and imprint. I have had situations where patients did not keep medications in their labeled pill bottles. Being able to assess what medications a patient takes helps to determine a patients current medical history. Epocrates is a free app that also has a premium account giving you access to disease databases as well as clinical reports and studies. For my use and budget the free app does the job as the one drug reference guide that is never out of date.

Emergency Medical Spanish – iTunes Link
Working in Southern California provides many challenges that are specific to this region. One particular challenge is patients that are Spanish speaking only. We have a sizable population that speak little or no English. My Spanish is very limited and sometimes there are no bilingual people on scene to assist. That is when I reach for Mavro’s Emergency Medical Spanish app. The questions are phrased in "yes or no" or number format to ease the difficulty in understanding the patients responses. The interface looks just like the real life flip books that Mavro sells. You select a subject like Cardiac, Stroke, or OPQRST,and it brings you to a list of questions to ask. Here is where the iPhone app really shines. When you press on the phrase, a prerecorded audio is played speaking the phrase for you. It takes away all the hassle over butchering the Spanish and improves the likelihood that you will obtain required information accurately. As you use the app you find yourself going to certain phrases more than others. You can select any phrase and add it to a favorites tab for quick access. This app will never be as good as learning Spanish or having a translator on scene, but in a pinch it is an invaluable tool.

Medical Calculator – iTunes Link
Calculating dosages isn’t very hard for me. I know some people find it challenging, especially when dealing with drip rates and medications mixed in saline bags. Even though I can calculate dosages in my head without much trouble, I still prefer to double check my numbers with a calculator or paper before administration. Medical Calculator provides me with every possible score, calculation, and converter that I would ever need. Like most apps, it lets me mark my favorites to show up in a special list for easy access. Medical calculator not only calculates IV dosages and infusions, but it also converts pounds to kilograms, quickly calculates ages based on birthdays, and even has scores like APGAR for newborns. The interface is very basic but having a quick utility to double check myself is always a good idea.

Eponyms – iTunes Link
Most people have never heard of the word eponym. An eponym in the medical field is a disease that is named after a person. A very common example of eponyms is Alzheimer’s disease, named after the neuropathologist Alois Alzheimer who first described the disease. There are literally thousands of these diseases, and most of them are quite rare. Having to care for a patient with a disease you have not heard of can be difficult. Eponyms iPhone app helps by providing pertinent information about these diseases, as well as the system of the body that they effect. I haven’t personally had to use this app, but I have it just in case I do run into someone who has Dacie’s syndrome or Batten’s disease.

This only scratches the surface when it comes to iPhone app for the medical field. Most applications either try and improve on the pen and paper with specially designed tracking form (like in the case of triaging large number of patients), or are reference material (such as county protocols). I always try and stay open to new tools in hopes of enhancing my ability to provide patient care. In my field it is important to diversify your tools because the situations we face everyday change constantly and we have to be able to come up with unconventional solutions. If you know about a new app that you think might be of interest, let me know in the comments.