Last week, we discussed a recently published randomized control trial that demonstrated how the use of the iResus app, developed by the United Kingdom’s Resuscitation Council, improved the performance of advanced life support-certified physicians during simulated cardiac arrests.
The UK’s Resuscitation Council had commissioned University of Washington anesthesiologist Daniel Low, medical director of iMobileMedic.com, to help develop the free iResus app for the iPhone with the hope of improving healthcare professional performance in emergency scenarios, with the original version of iResus debuting in January 2010.
In addition to iResus, iMobileMedic has also developed other medical apps that include iNAP3 (statistics of outcomes following regional anesthesia), iDAS (protocols from the Difficult Airway Society), and iGasLog (professional case logging for anesthetists). Read below the jump for how the iResus app can help improve your abilities to perform in advanced life support/resuscitation situations.
The iResus app opens with a home screen that features Guidelines, Alerts, News, Settings, and Topics of Interest.
The Guidelines, of course, is where the prime utility of iResus resides. While iResus offers both 8 Adult and 5 Pediatric protocols, here we’ll take a look at an Adult protocol (advanced life support) to demonstrate how iResus works.
As shown above, iResus offers a wide menu of resuscitation guidelines, including BLS (basic life support), ALS (advanced life support), algorithms for tachycardia and bradycardia, guidelines for choking and anaphylaxis, use of AED’s (automated external defibrillators), and in-hospital resuscitation. Here, we’ll take a closer look at ALS.
Clicking on a set of guidelines brings up the start screen for the chosen algorithm. Of note, clicking on the “Overview” button in the bottom left corner at any screen displays the complete algorithm, allowing for a touch to expand a particular area of the algorithm for quick access. Otherwise, the user interface facilitates easy following of the algorithm in a decision-tree format. As shown here, the ALS guidelines advise calling the resuscitation team, quickly beginning 30:2 CPR, and attaching a defibrillator/monitor.
Clicking “Next” directs the user to assess the rhythm, with different pathways for shockable (v-fib or pulseless v-tach) or non-shockable (pulseless electrical activity or asystole) rhythms or the return of spontaneous circulation. For our example, let’s assume the patient has v-fib.
iResus thus directs us to give 1 shock and resume CPR for 2 minutes, while assessing for reversible causes. Clicking on any of the red clipboards offers more detailed information. For example, clicking on the clipboard next to reversible causes displays the familiar “H’s and T’s” of cardiac arrests. Clicking “Next” at this point directs us to again assess the patient’s rhythm.
Let’s pretend that after our interventions above, our patient has a return of his circulation at this point. iResus advises us on immediate post-cardiac arrest management, including the hypothermia protocol.
The “Doses” button on the bottom bar can be clicked at any time to display dosing parameters and indications for medications, including adrenaline and amiodarone in this example.
Similarly, the other protocols in the iResus app offer clear and concise guidelines on how to deal with the emergency situations listed above via interactive decision-tree formats. Also of note, after the user exits the app, the prior screen appears on re-starting the app.
As for the other links from the home screen, “Alerts” provides updates on any upcoming app fixes or help desk unavailability.
Next, the “News” link offers a welcome and the most recent updates to the guidelines contained in the app. Of note, the iResus app automatically detects and downloads any updated guidelines from the UK Resuscitation Council, allowing it to display the most up-to-date resuscitation protocols.
As for the randomized clinical trial we discussed last week on this site, it demonstrated that ALS-trained physicians who had the iResus app available to them performed better in simulated cardiac arrests than those physicians without access to the app.
While these situations were simulated and not actual clinical emergencies, the results suggest there may be a benefit in terms of patient outcomes to physicians using the iResus app in clinical settings; however, of course, further studies would be necessary to evaluate this hypothesis.
Regardless, the results of this study and the ease of use of the iResus app reviewed here embolden the growing case for the increased use of cognitive aids via mobile technology to improve patient care in clinical settings. While there may exist hesitancy among some physicians to rely on cognitive aids in the practice of medicine for fear of appearing incompetent (as noted in the study), we at iMedicalApps believe that mobile medical technology offers great potential and promise to improve patient care and safety.
iResus app is FREE in the iTunes store.
- Sponsored by the UK Resuscitation Council, this app is FREE for all users
- Intuitive user interface makes iResus quick to use and easy to master
- iResus pulls its data from a central server, ensuring that it automatically detects and downloads updated guidelines from the UK Resuscitation Council
- One concern we shared last week involved receiving a phone call or text message while using the iResus app—when using the app (i.e., an emergency), it might be best to allow for no interruptions
- The iResus app is a must-have for any healthcare provider, as it offers free, easily accessible and navigable resuscitation guidelines for emergency situations.
- While definitely not a replacement for proper ACLS training and certification, we highly recommend downloading the app and familiarizing oneself with it for potential use in such situations. Kudos to the UK Resuscitation Council for commissioning and sponsoring this app with the goal of improving patient care!
iTunes Link: iResus
App Name: iResus
Company website: www.imobilemedic.com