EMS apps—small, EMS-specific applications that run on smartphones—are proving to be extremely valuable tools for EMTs. Collectively they bring sophisticated lifesaving technologies and knowledge bases to wherever an EMT is working, even in the remotest of areas.
“There are several apps out there now useful to EMS,” says Josh Mularella, DO, owner of Denali Apps and an emergency medicine resident at Einstein Medical Center in Philadelphia. “These range from protocol apps to drug references and hazmat guides. Some are even designed for prehospital documentation of patient encounters.”
Worth noting: “Most developers of EMS apps realize these will be used out in the field and that sometimes a wireless signal will not be available,” Mularella adds. “Because of that, most of these apps (including all of mine) are designed to have all the content within the app itself. Therefore, they will run with or without cell coverage or Internet access.”
All kinds of EMS apps are available through specific makers’ websites or third-party retailers like iTunes.com. Additionally, a simple Google search using the words EMS apps reveals a stunning range of apps for this medical sector.
Example #1: The popular and free Epocrates Rx app provides EMTs with a comprehensive drug reference guide right on their iPhones and Android handsets. Epocrates Rx lets users search specific drugs and their effects using brand names, generic alternatives and over-the-counter (OTC) versions.
“Epocrates Rx includes thousands of brand, generic and OTC medicines, dosing information, adverse reactions, black box warnings and a pill ID tool,” says Marianne Braunstein, Epocrates’ VP of product management. “It also features MultiCheck, our comprehensive drug interaction checker, which allows users to enter up to 30 prescription and OTC medications at a time and instantly review potential interactions.”
EMTs need a way to stay updated on the most important drug and diagnostic information, which keeps changing as new products are introduced. This is where an EMS app like Epocrates Rx can help: “There are millions of drug-drug interactions, even with OTC or alternative medicines, that no one person can memorize, and our MultiCheck product allows users to type in the medications and view potential contraindications or adverse effects on the spot,” says Braunstein. “For emergency responders, Epocrates can also be helpful in identifying mystery pills through shape and color characteristics.”
One last perk: The Epocrates app lets its users—not just EMTs, but physicians and nurses—connect directly to drug manufacturers to ask clinical questions.
All of this capability is free. Meanwhile, “for an annual $159 subscription fee, clinicians can upgrade to Epocrates Essentials, a clinical suite with additional disease content and diagnostic tools,” Braunstein notes. “This version also provides access to treatment guidelines, lab tests and panels with reference ranges.”
Example #2: Time is precious at an accident scene, especially if an air ambulance has to be called. To reduce waiting times Northwest MedStar, a nonprofit air ambulance service based in Washington, has created the MedStar Alert app.
This free EMS app lets an EMT send GPS coordinates from their smartphone to Northwest MedStar’s Communication Center. The data puts MedStar on alert, allowing them to determine which helicopter is nearest the scene and how long it would take to fly there if needed. A crew is put on standby at the same time. If the responding EMT subsequently decides helicopter transport is required, this app ensures it is ready to go as soon as possible.
“This is an innovative way to let that mobile device aid in the care of our customers by helping reduce our on-scene times within the golden hour,” notes Howard Johnson III, a division chief with Spokane County Fire District #4 in Chattaroy, WA.
Denali Apps also focuses on the emergency medicine market. “We have one app, called ERres, which is more suitable for doctors, nurses, techs and other hospital-based staff but has a lot of great info for prehospital workers too,” Mularella says. “Additionally we have developed EMS statewide protocol apps for several states that let providers look up protocols in an easy-to-navigate mobile app.”
To date Denali has such apps for the states of Maine, Massachusetts and Pennsylvania under the respective names of MEems, MAems and PAems. Available for $1.99 at itunes.apple.com, each app “contains the official statewide protocols broken down into individual sections for quicker access,” says the iTunes Web page. “No one can remember hundreds of pages of protocols, especially in an emergency situation...that’s what smartphones are for!”
EMS apps also exist to log critical events, manage triage at mass-casualty incidents and take detailed field notes on patient conditions, among others.
“Some take photos of an ECG or accident scene that can be sent to a receiving hospital,” says Eveline Bisson. She is vice chair of the Association of Air Medical Services’ (AAMS) board of directors, as well as Northwest MedStar’s program director in Spokane Valley, WA. “Some ePCRs are starting to integrate with apps to provide a mobile method of entering some of the patient care information through a smartphone,” Bisson adds. “There are so many more ways people are starting to think of apps as support tools for the field—these are just a few.”
For EMTs who embrace apps, however, there are some limitations to take into account when selecting and deploying them.
The first is that all apps are not created equal. Given that EMS is literally a business of life or death, it is critically important for EMTs and their agencies to choose EMS apps that are the best of their breed.
How do you know? “As a rule, the app should be easy to use and provide some useful function,” Bisson says. “It also must fulfill the intended function, so in regard to EMS apps, if you promote an app for some useful purpose, the app better fulfill that purpose, or it will fail.”
Apps should also reduce an EMT’s workload, rather than increase it by demanding time and attention to be mastered. “If the app creates more complication than doing that same task without the app, it will fail,” says Bisson. “The app is supposed to make life easier, not harder.”
The second limitation is finding the right apps. Given that they’re generally found on the Web—not always the most reputable source for products—buyers have to be extra careful in assessing app quality and suitability.
Fortunately, there are ways to steer yourself right, says Mularella. For instance, “If you’re looking to get apps for your mobile device, the best places to look are probably the various app stores (iTunes and Google Play) and the various EMS-related blogs and Facebook pages out there,” he explains. “On the other hand, if you’re looking to get into the app development game yourself, I highly recommend checking out buzztouch.com. They help anyone, regardless of prior coding experience, develop apps you can sell on your own.”
That’s right: It is possible for an EMT to develop an app that meets the needs of themselves or their agency and, if it’s a good app, be able to sell it online, making money for themselves, their employer or both.
Users of smartphones know these devices can be very brittle in the wrong circumstances. This is why it makes sense to fit them into hardened cases with screen protection wherever possible. This said, EMTs should do their homework when selecting the right case for their iPhone or Android. There have been instances where case manufacturers promise to protect phones from water damage, only to declare that their warranty only covers leaks, not a phone being soaked and destroyed.
In the same vein, carry an extra battery for your smartphone or an external power supply (such as a rechargeable battery) in your pocket. Car chargers are also a smart idea, but remember not to recharge your phone every second of the day. This could cause its battery to develop “battery memory,” a condition where the battery quickly loses power after minimal usage. Generally, batteries last longest when they are fully drained of power before being recharged.
Why Has EMS Been Slow to Embrace Apps?
The first iPhone was released on June 29, 2007. By June 2012, 400 million had been sold worldwide, according to Apple. The first Android phone came out in October 2008. According to Google, 333.6 million Android handsets have been shipped since.
Clearly, smart phones have become mass-market for personal use, and EMTs are among their most avid users. Yet the EMS industry as a whole is still grappling with smart phones’ possibilities.
Why the hesitation? “I think the EMS community is in the early stages of understanding the value apps can add,” says Bisson. “It is still an emerging technology for EMS, and it will be very interesting to watch how it is used by agencies in different parts of the country for varied purposes.”
There are a number of other reasons EMS agencies are going slow on apps.
First, smart phones are a consumer technology. First responders have historically shied away from consumer tech, preferring to use more robust professional-grade radios and computers. This is why makers of rugged radio equipment such as Motorola and Harris have become key players in first responder communications, and why comparatively fragile smart phones are may still be viewed with suspicion by senior public safety commanders.
The second sticking point is security. Compared to professional-grade comms equipment, consumer smart phones are vulnerable to hacking and hijacking. Proprietary professional-grade equipment is much harder to hack, both because its systems are designed to be secure and simply because its small-base, specialized platforms aren’t popular with hackers.
Then there’s the issue of reliability: Consumer wireless networks are among the first to fail during natural disasters or to be overloaded with calls if they do remain in service. First responders cannot afford to lose service, whatever the reason. (This is why smart phones should be used as supplements to dedicated first responder radio networks, rather than as replacements.)
Another reason smart phones encounter resistance is that they are, well, so new. This resistance is simply due to demographics: The senior officials currently in command didn’t grow up with smart phones, the Web and social media, and so they can be uncomfortable bringing this technology into the public-safety space.
This resistance will decline over time, as today’s tech-comfortable users move into command positions. But for now, they’re not in charge.
“It will only grow as more people and agencies begin to use smart phones and as the cellular network grows, decreasing the gaps in coverage,” Bisson says. “It’s a foregone conclusion, in my mind, that apps for EMS will only increase over time.”
EMS apps can be a valuable addition to any EMT’s toolkit. They can bring medical knowledge to scenes where it’s needed, improve the accuracy of diagnoses and summon air support as quickly as possible.
Finally, many EMS apps are free and just waiting to be downloaded from the Web and put to work. When money is tight, this kind of free capability is too good to be ignored.
James Careless is a freelance writer with extensive experience covering computer technologies.