It’s easy to feel lost in the new world of medical applications. We’re here to help, downloading the apps most relevant to emergency medicine and distilling them down to their essential parts. This month we start with drug reference apps.
EMRA’s Antibiotics Guide
This is the app version of the antibiotics bible that’s sent to all EM residents as part of their EMRA membership. True to EMRA’s style, it has a simple user-friendly design, is not over-crowded with information and is designed to be a bit less comprehensive. Some great features: general pricing information; an electronic “antiobiogram” (a chart summarizing the sensitivities of bacteria classes to each antibiotic), as well as a notes section. The main downside is price. DON’T FORGET: incorporate local antibiotic sensitivities when choosing an antibiotic.
Epocrates was just gobbled up by EHR vendor Athenahealth, and for good reason: it’s amazingly popular due to its great balance between powerful features and user-friendliness. Features such as Pill ID and drug interaction checker add significant value. And we love the drug pricing info for the “Doc, I just can’t afford my meds” patients – helping us choose the most reasonable option for those without drug coverage. One can even search hundreds of infectious diseases and get empiric and specific treatments. Epocrates finds a happy medium between speed and comprehensiveness.
Developed by WebMD, a large public company that provides medical info to consumers and professionals (think eMedicine, etc), Medscape is the most comprehensive app we reviewed. This may come at the cost of speed and usability, with busy screens and often too many options. We love that the drug interaction checker includes herbal and dietary supplements. For the visual learners there are over 2000 images and 150 videos. Extra features include updated specialty-specific news, and a clever procedure section includes useful tips and video tutorials.
Micromedex is the quickest and easiest app we reviewed. It doesn’t even ask for a registration. A unique feature is the Patient Teaching section, with patient-centered info such as medication instructions, side effects to expect and more. The toxicology section will be a favorite among EPs, as it explains what to expect in overdoses. We were a bit turned off by pop-ups asking us to “like” them on Facebook or to purchase another product.
Nothing is more intense than a crashing peds patients. Pedi Stat presents material in a concise color-coded format, substantially limiting room for error. Once you enter a weight (or alternatively, patient age or length), the rest is easy – with automatic dosing calculations as you browse meds. Also included are PALS algorithms, and a dedicated airway section including RSI meds and pearls. So if you can’t find the Broselow Tape at least you have your pocket brain.
All in all, we thought all of the apps worked well, and for the most part were quite similar. But they did differ in several features, layout and design, and most importantly the classic tradeoff between simplicity and comprehensiveness. What’s perfect for you depends on what you’re looking for, what stage of training you are in, and how much info you prefer in your pocket brain. The earlier you are in training and the less familiar you are with apps, the more you may appreciate the concise apps. A seasoned EP who is familiar with apps may want one with a larger feature set.
That said, if we were stranded on a desert island and could only have one drug reference app (picture it), we would choose Medscape.
Eric Steinberg, DO is a EM resident at Beth Israel Medical Center of the Albert Einstein College of Medicine.
Joseph Habboushe, MD MBA is an attending at Beth Israel. Joe is the creator and editor of EMRA’s Basics of Emergency Medicine pocket guide & iPhone app.