Many paramedics rely on a BlackBerry smartphone as a key resource -- not just for communication, but for access to a range of medical reference solutions from companies like PEPID, Skyscape and Epocrates.
However, very few municipalities and ambulance companies supply the devices to their emergency personnel.
According to Bill Raynovich, associate professor and director of EMS education at Creighton University in Omaha, Neb., the margins are too small for most companies to justify the expense. "An extra investment like that isn't necessarily seen as worth it," he says.
Creighton University paramedic program director Mike Miller, a PEPID user, notes that there are logistical issues as well. "If I run an ambulance service that has 10 ambulances... do I get 10 BlackBerrys and they change hands every shift, or do I have to put one in all 100 of my employees' hands so that they all have a reference?" he asks. "And then who pays for the phone service and everything else that comes along with it?"
As a result, most paramedics are left to make the purchase on their own. George Kinahan, a paramedic with Cataldo Ambulance Service in Somerville, Mass., says he's probably spent about $500 on Skyscape software for his BlackBerry Tour, including a drug identification app, a drug interaction guide, a Spanish-to-English medical guide, and many others.
The drug identification app Ident-A-Drug, Kinahan says, has proved particularly useful. "We [handle] a lot of drug overdoses on prescription drugs as well as street drugs... you just plug in the number that's on the pill, and it'll tell you exactly what that medication is," he says.
Kinahan says a common cause of overdoses is bowl parties. "The kids get all these prescription meds from their parents, they put them in a bowl, they mix them up, and they take whatever they want," he says. "When you go into something like that, you don't know what they took, and they're unconscious as you're working on them... so you can just punch in the numbers and it will tell you exactly what the meds are."
The alternative is to carry a pocket-sized reference manual or a flipchart -- which Kinahan says is inevitably slower to search through in an emergency, and can't possibly have as much information as the software. "They limit it to the most popular medications... and it's not constantly updated," he says.
Another helpful app is the multilingual medical guide. "I work in an urban area -- our population's mostly Portuguese and Hispanic," Kinahan says. "And I don't speak Spanish to save my life, and the words I do know would probably get me beat up -- so I have the Spanish-to-English medical guide, which works out great."
Paramedics can also pick up a BlackBerry for more basic reasons. Sam Snyder, a firefighter paramedic in Walpole, Mass., says that for him, the calendar is actually the most useful application on his BlackBerry Storm. "We work eight-day rotating shifts and I work two other jobs, so it's easy to keep my calendar straight with my wife -- honestly, that's the biggest reason why I went to a smartphone in the first place," he says.
Snyder uses Epocrates Essentials medical software on his BlackBerry, and like Kinahan, he says the drug reference is the most useful aspect of the app. "You get these elderly patients who take potentially 20 or 30 different medications every single day, all from different doctors... so if I think maybe something is happening because of their medications, I'll use the Epocrates, put some of the things in there, and see if in fact there would be an interaction," he says.
In contrast, Snyder says, more advanced guides and calculators aren't particularly useful in the field. "The idea is great of these calculators and little algorithms to walk you through taking care of a person, but you really don't have time to do that -- you need to know what you're doing on your own," he says. "It also doesn't look good to the patient if you say, 'Hey, I'd like to take care of you: hold on, let me look at my phone so I can decide what to do next...'"
Beyond the calendar and Epocrates Essentials, Snyder says it's also key to have reliable e-mail access, particularly in juggling three different jobs. "I can keep myself moving along all in one place in a parking lot in downtown Boston -- whereas in the past I used to try and take my laptop along," he says.
And Snyder says most paramedics he knows also have smartphones for that same basic reason: while waiting for the next call, it's nice to be able to stay connected in a myriad of ways. "A lot of them, they spend eight hours a day on Facebook on their BlackBerry -- and I will say that's an app I use a lot," he says. "Sitting in a truck, I use the Internet, I use my Epocrates, I use Facebook... and I play a game here and there."
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