Purpose of the App Review:

1) Will I know if my patient is eligible for tPA using this app?
2) Does it include all of the exclusion/inclusion criteria and contraindications?
3) Does it include the NIH Stroke Scale calculator?

Introduction:

When a patient comes in with a suspected stroke, you have a very short time (3 to 4.5 hours) to intervene.

Even for the seasoned ER physician, remembering all of the criteria, contraindications, relative contraindications etc. for tPA use is not easy.

BrainAttack is a quick, easy to use tool that helps providers recognize when to give tPA. BrainAttack was developed by PHI Consulting and includes a questionnaire format for the user to quickly determine what a patient’s NIH Stroke Scale is and if their patient is eligible for tPA or not.

User Interface:

The app has an introduction page which includes an option to go to the tPA eligibility tool or NIH Stroke Scale Assessment tool.

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When using the tPA eligibility tool, the app starts with five inclusion criteria questions.

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When any of the questions are answered, the foreground for that answered question will turn green, yellow, or red to indicate whether or not the patient meets that criteria.

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The app will then advance to an exclusion criteria page.

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After that, the app will proceed to the caution criteria. If at any stage the patient does not meet the criteria, the app will stop asking questions and will describe why the patient is not eligible with appropriate citations.

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If the patient is eligible for tPA, the app will recommend tPA dosing with instructions.

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There is also an NIH Stroke Scale Assessment included in the app. This is really quite useful.

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The user can email or print the information from the app after the tPA assessment tool and NIH Stroke Scale has been filled out so the information can be put in the chart. However, it does not print or email a PDF, it is just the text. The printer tool requires your device to be wirelessly connected to a printer.

Price:

  • $5.99

Likes:

  • Very quickly determine tPA eligibility of patient
  • Includes NIH Stroke Scale Assessment tool
  • The app allows you to print or email the NIH Stroke Scale or tPA eligibility tool results (blank copy or a copy with all of the information the user inputs into the assessment tool) so that you may add it to the patient’s chart. Unfortunately, it does not print to PDF
  • Includes tPA dosing

Dislikes:

  • There are no citations or evidence for the recommendations this app provides
  • Though you can email/print from this app, it does not print to PDF which might make it cumbersome to include in EMR charts
  • For $5.99, I would expect the app to have more functionality

Healthcare providers that would benefit from the app:

  • ER physicians
  • Neurologists
  • Internists/Hospitalists

Conclusion:

  • BrainAttack is a quick and dirty tPA eligibility tool.
  • BrainAttack also includes a NIH Stroke Scale Scoring tool.
  • The app is simple and easy to use, it is in a questionnaire format.
  • The app includes inclusion criteria, exclusion criteria, some special considerations, tPA dosing, and an NIH Stroke Assessment tool.
  • The app does not include citations or evidence for the content – there are dosing and tPA recommendations made on this app, adding some citations would help build credibility. Additionally, the tPA guidelines are subject to change and the user should be informed about where this information came from to ensure it is the most up to date recommendation.

iMedicalApps recommended?

  • Yes

iTunes Link

Rating:
Overall: 3.5/5 Stars
User Interface:  3/5 Stars. Simple app, intuitive to use. Adding citations would improve the reliability of the app.
Multimedia Coverage: 3/5 Stars. The app only includes questions. There is no multimedia used in the app (no pictures, figures, videos, etc), but those would clutter the app and deter from its primary purpose.
Price: 3/5 Stars. The app costs $5.99, which is the cost of the convenience of being able to pull the information quickly on your phone. However, I do think it is costly for what is offered. For docs who encounter stroke patients often, though, it is still worth the cost.
Real World Applicability: 5/5 Stars. For neurologists/Er doctors, this app can be used often

Compatibility: iPhone, iPad (compatible), iPod Touch (3rd generation and later)
Requires: iOS 5.0 or later