Regional anesthesia app gives guidelines for anticoagulation therapies

The American Society of Regional Anesthesia created a medical app that provides their guidelines for antithrombotic and thrombolytic therapy use in the context of regional anesthesia procedures. The app is user specific as the procedures are all regional anesthesia related including neuraxial block, deep plexus block, and superficial peripheral block.

The opening screen is a list of the 28 medications covered. The list is fairly extensive and even nicely separates out various dosing schemes such as twice daily versus three times daily versus therapeutic heparin.

Next to each drug is an information button that conveniently guides the user to the full 2010 guidelines, the executive summary, or the drug’s mechanism of action. Medical apps that guide the user to helpful information while not cluttering the small screen on the phone are much easier to use. This app is successful as it presents the evidence for each recommendation (the guidelines) as well as background information helpful for the user (the mechanism of action) without clogging up the initial screen.

If you click on the drug name you are led to a separate screen to choose among various procedures including neuraxial block, deep plexus block, and superficial peripheral block. Once you click from among these options you are taken to the next selection screen. This allows you to select from among the parts of the procedure including placing the block, restarting after the procedure, removing the catheter or restarting after the catheter removal. Once you make a selection you are taken to the answer screen.

This is one area where the app could add more direct access to the information. As I browsed various drugs, several of the screens would take me to the answer screen which had relatively simple information. For instance, the recommendation for superficial peripheral block on abciximab is “No recommendation” e.g. use your professional judgment.

It would be easier for the user to see a brief answer with a full answer appearing if clicked. This would save the user from clicking an extra time to only get “No recommendation.”

Another option that would work better is having another option at the initial screen where the user can pick from drug class rather than individual drugs as most recommendations are made on a class basis. The option of picking from individual drugs or classes (GP IIb/IIIa, LMWH, etc) would allow the user to bypass some screens when they had a class based question rather than an individual drug. As you can see the individual recommendation is often class based rather than simply drug based.

Healthcare providers that would benefit from the app:

• Medical students,mid-levels, residents, and physicians in the field of regional anesthesiology.

Evidence based medicine:

• Well done. The full text guideline is available throughout application