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January 11, 2017
New app to aid EMS providers in pediatric emergencies
By Karen Herzog
MILWAUKEE — A new mobile app that could save emergency department physicians and paramedics precious time while resuscitating a child has been developed through a local partnership.
It's called the First Five Minutes app, and it was launched by the University of Wisconsin-Milwaukee's App Brewery, the Medical College of Wisconsin and Children's Hospital of Wisconsin. It's still in a limited trial and won't be publicly available until later this year through the Apple Store and Google download.
Here's how it works:
Imagine a child whose heart has stopped. A physician or paramedic has minutes to act. The child needs an epinephrine injection to restart the heart, but the dosage must be precisely calculated to the child's size, so the physician or paramedic either must rely on memory, or figure out the dosage with a calculator and a flip-book of charts.
Meanwhile, the clock is ticking.
Using the First Five Minutes app on a smartphone or tablet, emergency medical personnel can enter the child's age or weight, click to confirm it, and immediately get an easy-to-read chart with the correct, standardized medication dose. If all that's known is the child's age, the medical provider can make a slight adjustment if the child is smaller or larger than average.
The chart includes five categories of information — color-coded for a quick read — that are key to pediatric cardiopulmonary resuscitation: CPR drugs, dysrhythmia drugs, neurobiological drugs, RSI drugs and equipment sizes.
Below the equipment header is a list of items used during CPR, such as a chest tube. The size of chest tube needed depends on the size of the child.
While the app is for a mobile device, it doesn't require wifi access.
Children's Hospital of Wisconsin projects the app onto a screen in the resuscitation room, so all staff in the room can see the information.
"Seconds can make a difference for really sick kids," said Amy Drendel, a pediatric emergency medicine physician at Children's who worked with two other pediatric emergency medicine physicians and a pediatric nurse there to brainstorm the app concept.
"Every minute you're not getting the heart pumping through the body, lack of oxygen to the brain is a problem," Drendel said. "This is something that just needed the right collaborators to come together."
The pediatricians involved with the app also are associate professors of pediatrics at the Medical College of Wisconsin. Besides Drendel, the team included pediatricians Danny Thomas and Michael Meyer.
Robyn Saxe, a pediatric nurse and former flight nurse, was the fourth team member. The Medical College of Wisconsin provided funding.
UWM student mobile app developers started coding the First Five Minutes app at the end of May, according to Dustin Hahn, project manager for the App Brewery. They delivered the first beta version of the app in July.
Developer Evan Timmermann, a UWM senior from Wisconsin Rapids majoring in computer science, explained that the first step was to digitize the book on which the app is based. Then they built the app so that information could be calculated and read quickly, he said.
"Throughout this project, I kept thinking this could save lives," Timmermann said.
The Medical College of Wisconsin owns the intellectual property of the mobile app, and at this time, the app is free, though limited in availability.
There are other medication dosing mobile apps, Drendel said, "but there were too many clicks to go through," she said. "We wanted one click to make all the information available. It's so much better than the variability that 10 doctors lined up would spontaneously come up with."
Emergency department physicians at Children's use the new app every time there's a resuscitation, Drendel said.
UWM's AppBrewery mobile innovation lab originated with a mobile apps class in the university's information studies department several years ago. It currently employs six students: five undergrads and one graduate student.
The lab has developed apps to help start-ups, researchers, non-profits and government.
Among its most recent projects: A Streets of Old Milwaukee Tour app for the Milwaukee Public Museum; an app developed with the Medical College of Wisconsin to help diagnose and track treatment of head injuries among young athletes; an app developed with Waukesha County public libraries to help parents track books they read to their preschoolers, and the Waukesha County Recycles app for the Waukesha County Parks and Land Use Department.
To date, UWM's App Brewery has worked on 30 mobile applications, Hahn said. Some have future releases planned. Five other projects are in pre-development phase.
The lab welcomes more real-world app projects, Hahn said.