Monthly Archives: September 2014

Test pilots wanted! Auckland HEMS app goes live

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We are delighted to announce the release of the Auckland HEMS mobile app!

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ALERT! January 2015: Since the publication of this post the app has been updated, including the launch of the Auckland HEMS simulation-based prehospital care curriculum podcasts. You can read  about the latest additions by clicking HERE

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This app is a work in progress, and will be a living, dynamic project.

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Auckland HEMS home screen

We are very keen to have feedback regarding app development and improvement from the prehospital, aeromedical, and emergency medicine communities.

At the heart of the app are the emergency situation checklists that have been developed by Dr Robert Gooch (Canadian Emergency Medicine trainee and recent Auckland HEMS Fellow) and Dr Chris Denny (Auckland HEMS Medical Director).

Auckland HEMS also gratefully acknowledges the efforts of the pilots, paramedics, and crewmen who took place in the simulation-based usability-testing of the checklists, the work of Atul Gawande, and the international HEMS fellowship for allowing Dr Gooch to complete this patient safety initiative.

emergency checklist menu

The app also contains other clinical and non-clinical resources.

How can we make it better? We would like to hear your thoughts.

Please use the feedback button in the app, or post comments below.

The app was developed using a platform called ‘ibuildapp‘. This is a web-based subscription service that has the following features:

  • straightforward user interface to construct and test the app – if you can create a powerpoint presentation, you can build an app!
  • NO coding required
  • apps created are functional on both iOS and Android
  • immediate updating – alterations to the master version will appear on user’s versions the next time they open the app
  • low startup costs compared to having an app professionally coded

The monthly subscription cost to Auckland HEMS increases as more users download the app. As a result we have had to introduce a small charge for iOS users to offset our ongoing costs. Due to some inflexibility regarding price alterations on Google Play (and a failure to read the fine print!), the app will remain free for Android users – it’s your lucky day…

No individual will make a personal profit from this project; any income above our development and subscription costs will go towards further app development and other Auckland HEMS educational and training activities.

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Our vision is to use a large team of ‘test pilots’ to make the app as effective as possible for clinical and operational use prior to creating a professionally coded ‘Auckland HEMS 2.0′.

ARE YOU UP FOR THE CHALLENGE?

A test pilot who WAS up for the challenge: Chuck Yeager and the Bell X1

A test pilot who WAS up for the challenge: Chuck Yeager and the Bell X1

Some improvement suggestions will be possible within the technical features of ‘ibuildapp’, but many will not, and these will be added to the future development list for version 2.0.

TO DOWNLOAD THE APP:

Click HERE for iOS users

Click HERE for Android users

Thank you for being a part of the Auckland HEMS team!

Auckland HEMS Checklist Reference Manual

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Dear colleagues,

In June of this year our Canadian HEMS Fellow Dr. Robert Gooch shared one of our emergency checklists with the Prehospital and Retrieval Medicine (PHARM) community. Thank you to those of you who provided feedback on this initiative. We continue to draw inspiration from the work of Dr. Atul Gawande. http://atulgawande.com/

Now, in the spirit of Free Open Access Medicine, we are keen to share our complete Auckland HEMS Checklist Reference Manual with the PHARM community. At the start of September we made this manual operational within our service.

Innovation is one element of success; implementation is another core element.  http://www.sjtrem.com/content/19/1/53/abstract This article emphasizes the importance of end-users ‘the sharp end’ being involved throughout the checklist development process. We are fortunate to have input into this checklist from our pilots, crewmen, paramedics and doctors. Even our CEO (who is also a pilot) has shared his experience.

We see these checklists as a living document, which will only improve with use, reflection and feedback.Please download, test, then let us know what you think. Below, please find our Checklist SOP:

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Auckland HEMS Medical Checklists

Standard Operating Procedure (SOP)

  1. Any crew member may activate an Emergency Medical Checklist (EMC) at any time.

  1. In an emergency, a team member will assume the role of lead clinician.

  1. The lead clinician will take any required immediate actions AND direct a team member to read the appropriate emergency medical checklist (EMC). Immediate actions include three steps:

    1. Identify

    2. Understand

    3. Respond

  1. The lead clinician may delegate tasks to other team members (if available). The priority remains direct patient care. Aviation uses the mnemonic ‘ANCA’:

    1. Aviate – Care for the patient

    2. Navigate – Maintain situation awareness and anticipate next steps

    3. Communicate

    4. Administrate

  1. Our checklist format is ‘Challenge-and-Response.’ Each step has a specific actionable response. If an inappropriate response is given, the checklist reader will prompt the lead clinician for the appropriate response. “Brevity is the soul of wit.” – W. Shakespeare, Hamlet.

  1. The checklist reader will not move on from a step until an appropriate response is given.

    1. Stop the checklist

    2. Complete the respective task

    3. Continue the checklist

  1. A checklist may be aborted if:

    1. The physiologic abnormality resolves and the patient’s condition improves

    2. The team is confident the physiologic abnormality is not an emergency

    3. The checklist is unsafe in the given clinical scenario

  1. Some patients may have multiple physiologic abnormalities. It is up to the clinician’s discretion which checklist is used first. Multiple checklists may be used sequentially. In all situations, the clinicians must assess patient and use good judgment to determine the safest course of action.

  1. Emergency checklists are intended as a cognitive aid to improve initial management of time-critical scenarios. A checklist is neither a teaching tool nor an algorithm. In some cases, further management steps may be required once the checklist has been completed.

  1. Usually, time is available to assess the situation before corrective action is started. All actions must be coordinated and performed in a deliberate, systematic manner.

  1. Reference: http://www.projectcheck.org/

 
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