Key iPhone apps for when your patient goes pulseless

First, check your pulse, then, open this app.

If it were that easy, we could all be stars of the Japanese TV drama as referenced in the Code Blue series. However, real life codes are usually all too hectic and stress inducing especially for the new graduating medical class that just started their intern year. After our initial article on the crucial apps for intern year, we are reviewing the top iPhone “code” apps available on the market.

We should mention the obvious caveat — you should know how to handle code blue / ACLS scenarios without having to use an app or even without having to use the commonly used pamphlets people carry with them.  That said — these apps can often times help you control the adrenaline that is flooding your veins in these high acuity settings.

Medirate

Not many people wear watches and there is often either no clock or a broken clock on the wall- this is what I learned when I was in the room of a patient who was sick but not coding (not all patients are hooked up to telemetry 24/7). I have tried, mildly successfully, to use the clock on the iPhone to time out 6-10 seconds and then multiply that out for my heart or respiratory rate. The creators of Medirate had this dilemma in mind and created an exceedingly simple tool to fix it.

The app’s one and only screen, shown above, has a large button which you press whenever you either see a breath or feel a heartbeat. After literally two presses the display changes to a number of either breaths or beats per minute. I’ve testing it a few times and it is surprisingly helpful and accurate.

Uh oh. The heart rate you calculated is 25. As the nurse rolls in the code cart and slaps on the zoll monitors (which will follow the patient’s heart and respiratory rate as well as show you a tele strip) it is time to close Medirate and open one of the following apps.

As a note, if you have not already sent a frantic text to your senior resident now is also the time to send that text as well as put your phone into “airplane” mode so calls, etc do not cramp your style.

Rescue Code

This medical app is the simplest of the code tracking applications. Once you click past a “terms of use screen,” which sadly appears every time you open the application rather than only once, you are taken to the opening page and can start tracking your code.

Once you click start code you are immediately taken to a screen to pick your rhythm. Your choice then immediately takes you to a medication screen. This is a little harsh and unhelpful. Often, in real life you have a code started and it takes a few minutes–even in the emergency room where staff is prepared–to give medications. Why force the user to give a medication when this may not accurately represent what is happening?

After you pick your medication you are taken back to your initial timer screen. The problems at this point continues. Consider a patient who was in PEA but then transitions into bradycardia. With this app there is no way to change the rhythm! You are stuck in PEA. All the app allows is to go back to the medication page. Additionally, there is no way to log procedures.

Beyond the limitations of logging (not changing the rhythm and no procedure tracking), what really drives this app into my low recommendation is the very high price of $7.99. If the app was free I would recommend some suggestions and consider the app a work in progress, but asking this high a price for this level of quality is surprising.