Top 5 Apps for ER Nurses

 To work as a nurse in emergency medicine, you have to be quick on your feet, efficient, and knowledgeable. Drawing on information in life and death situations can be daunting. Sometimes, it can be difficult to think when you are stressed, overworked, and underfed. Using smartphone apps specific to emergency nursing can save you some brain power and offer a quick reference to ensure patient safety. Sure – googling is an option, but using smartphone apps specific to nursing or medical information can greatly improve the accuracy and utility of the information.

1. WikEM

   WikEM is an “online wiki and database of emergency medicine knowledge”, primarily intended for clinicians such as physicians or advanced practice providers. However, WikEM offers great information to those nurses who need to look up a new disease, refresh an old disease, or update their knowledge on various procedures, labs, or medications.
   
   All information on this database is specific to emergency medicine and will help you draw the need-to-know information. Just like a Wikipedia article, a convenient table of contents is offered to assist you to navigate to the desired information. Topics are not too wordy and are easy-to-read synthesized information specific to the emergency clinician.
   
   The best part about this app is that it is completely FREE to use. All you need to do is first create an account on their website. Afterward, you can use the website database or download the app and use your login information. You can choose to subscribe to get access to personalized lists and favorites, but this is only $5 dollars per year and helps them maintain free information for everyone.
   
   Information is continuously updated from their online database and ensures accurate and up-to-date information.

2. Critical – Medical Guide

   Critical – Medical Guide is a one-stop shop for all things critical care. This app can be used for really any nurse in the hospital setting but seems to specifically cater to the ED or ICU.
   
   This app “aims to assist by providing crucial medical guidelines, emergency medical references & materials” to use on-the-fly. Within it, there is information on ACLS algorithms, EKG interpretation, fluid and blood products, laboratory values, hemodynamics, ventilator management, and various assessments.
   
   In my opinion, one of the most useful features is the critical drips function, which gives you all the critical drips you may entail within the critical setting. Each drug offers a calculator, in which you enter the patient’s weight (in kg), the total dose and dilution amount, and the infusion rate. The app will give you a mg/hr and mL/hr rate. It offers a small slider which lets you adjust the mg/hr and titrate the medication effectively.
   
   Another helpful feature is the RSI tab, which gives you dosing calculators for common medications used in rapid sequence intubation. The app also offers many other features including a pediatrics critical tab, which overviews each Braslow weight including medication dosages and ET tube sizes. The app also has a “pharmacology” section which overviews the pharmacology, indications, and adverse effects of commonly used emergency drugs.
   
   Unfortunately, this app is not free. It comes with a one-time payment of $9.99. However, I have personally used this app in the ED and find it to be very helpful with my management of a critical patient.

3. Intravenous Medications: Gahart

   IV Meds boasts itself as “the #1 IV drug reference for 40 years”. Basically, this is your go-to resource for IV medications and drips. It provides comprehensive information regarding every type of IV drug.
   
   This includes comprehensive information on dosing, dose adjustments that may need to be made, dilution, compatibility, the rate of administration, drug actions, indications, contraindications, precautions, interactions, side effects, and antidotes.
   
   The app also offers calculators and charts for dilution and rate administration, although I find these to be a bit difficult to use and unsightly. There is an option to mark your favorites for quick-access in the critical setting.
   
   You can download the app for free, but unfortunately, to use the app you must pay $50. You can likely find all the information you need on google or other medication reference apps, but this app is specific to IV medications and offers convenience in the critical setting.

4. Eye Chart HD

   Eye Chart HD is a great app to utilize within the emergency setting. Any patient who presents with an eye complaint usually needs visual acuity tested. Unfortunately, most exam rooms do not have a Handy Snellen chart available. This means that you have to take the patient out to a common area and have them perform the visual acuity assessment in a less-than-ideal setting.
   
   The app will detect which phone you are using, and recommend an appropriate distance (such as 4 feet). This is ideal for testing at the end of the stretcher with the patient in high Fowler’s position. Assess the visual acuity as you normally would.
   
   The app also offers a “randomize” option, which randomizes the letters. You can also click “mirror” and test yourself in the mirror!
   The app also offers other visual acuity charts including Tumbling E, Sloan Chart, and a Landolt Chart.
   
   This app is FREE, but you can choose to pay $2.99 per month to get access to a randomized near-vision chart, Amsler grid, line isolation, and other specific eye chart features. However, this seems excessive for use in the emergency department, and I don’t recommend it.

5. Lab Values Medical Reference

   Lab Values + offers comprehensive information regarding lab values. The app separates the labs by system, but also has a search function.
   
   Within each lab, the app lists common “normal” values for the lab in both SI and US units. Additionally, it offers a description of the lab and the pathophysiologic significance. It also offers a differential for abnormal levels, as well as which lab vial color to draw. Please note that not every hospital utilizes the same colors. For example, a lab that may be run off of a gold tube at one facility may be run off of a mint tube at another.
   
   While not free, you can utilize this app with a one-time payment of $2.99, which is very affordable. You can likely find the information within this app elsewhere, but this app offers convenience and a pleasing aesthetic.

So there you have it – my Top 5 apps for ER Nurses. Have you used any of these apps in your ED? Are there any other apps that you use in the ER setting that you recommend? Comment below!