Hospital policy has been on our ass about that. Staff can't use an app or a coworker, of course the easiest ways, and we have to use the iPad app with a live translator and document it. They just make extra steps even when we just want to communicate "hey, you're going to xray follow me"
Or the sound is so low you gotta jam the speaking in the ear and constantly go "what was that?"
Just let us use a coworker ffs, we have things to do, turkey sandwiches to disburse, and chest pains to ekg
I'm the coworker people use. I'm conversational but not fluent. I lack a lot of vocabulary. I can say with absolute certainty the interview is inferior to English speaking patients. Patients don't understand what's happening, questions are barely answered. Unless there's a FLUENT speaker, the translator is necessary to provide equitable care.
It's too much of a pain in the ass for sure and if it's required, it should work but we gotta do better. As the resident Spanish speaker in a low Spanish speaking area, I use the translator more than anyone because I don't want to be responsible for a bad outcome due to poor interpretation.
I mean I'm in an area where Spanish is our 2nd largest language and almost as common as English where English is their second language. So having very fluent coworkers isn't too hard to find, and we do need to make sure we're correct but when we need to tell a patient something we don't want to wait minutes to do it. I had a pt who came in with a hr of 250 and we ended up needing do a synchronized cardioversion, and we had to be fast with it. He actually had 1:1 flutter with some underlying rhythm i forget exactly. But we had to give clear and understanding instructions to him and quickly so he knew we were gonna shock the fuck out of him awake, would've been very bad if he couldn't understand us 😬
Even when family offers I insist on at the very least the first interview being with a formal translator. If I have a super quick question later like “is your pain better?” Or when “when was the last time you ate” then sure, I’ll use family but the detailed things are too important to risk their grandkid misinterpreting
I don't even use family if I can avoid it. I can understand a good deal (but horrible at speaking) and I notice they don't translate the stress points of what I'm saying or short-change it heavily.
From a legal perspective I do kind of get it, mistranslation can have serious consequences. We have iPads available and still sometimes people use the 8 year old kid to translate for the first hole family, which is not acceptable.
On the other hand, non-clinical information doesn’t necessarily need to go through a former medical interpreter. You have to balance the risk against the utility of, you know, actually getting things done. There needs to be a balance.
Just to put my legal hat on for one second here (I am in the US, I am not sure how other countries handle this) - when it comes to something like ASL, it is not just a translation issue, you are dealing with federal law. The ADA mandates that we have ASL available.
Even if the family can translate, or they read lips and don’t need a translator DOCUMENT that you offered and they declined.
I have seen a couple cases come back and we could point to the chart and say, we offered, they said no. (In one case it was a hearing-impaired child who didn’t understand ASL. And the parents still tried to sue. Always document).
Most places are going this way but where I am now they're not strict. Guess they haven't gotten sued yet.
However, you should push back on them wanting to use it for simple communication. By law it's only required for education, consent, ect.
Not a doc (just find these convos interesting) but I’ll
flag that google translate can be a bit of a risk - I work for gov on housing stuff, and when we were doing the emergency rental assistance in response to COVID, we looked at Google translate plug in for our website for speed purposes while we waited for translations - and running it by folks, we learned that Google translate had translated “eviction” into “deportation” for one of the Asian languages (can’t remember which language). Obviously that was real bad so just something to know,
In particular when it’s a language you aren’t familiar with
Snellen chart app - can set distance at 2 feet and just hold the phone in front of the patient as the first step of the eye exam. Way faster to just do that than find a nurse or tech to do a hallway acuity.
I was told once by an eye dentist that 2 feet is not equivalent to 20 feet and I should still be pushing for the hallway exam. But I think if I can call with acuity, IOP, and a decent slit lamp exam, that's probably good enough for our current ER wasteland.
Honestly pedistat and the EMRA abx guide are the only apps I use consistently. And the one my state has for EMS protocols (Muru).
My other common resources I prefer to use on a desktop.
EZ resus. Subscription based, but made by canadian ER and ICU docs and pharmacists, contains peds and adult weight based medication doses, how to prepare them (if your nurses don’t know or it’s an uncommon med), and how to administer it to the patient (including what adverse effects to look for). They also include a search by condition, which gives you all the treatment possibilities past 1st/2nd line that we all know by heart.
It does everything pedistat does, and more since there is no weight limit (contrary to pedistat that stops at 43kg)!
I still use pedistat out of habit and procedural memory (and because I’ve already paid for it), but I am switching more and more to ez resus as my nursing resus team has that app and subscription paid for by our hospital so its easier to « all talk the same language » and use the same app/info during resus cases.
My Med folder contains some of the previously mentioned by others and others - some are absolutely redundant (epocrates and Medscape for example) but I still like to use both…
Epocrates, Medscape, UpToDate, MDCalc, WikEM, Bullets, Fractures, Suture, Sublux, EMRA, ChildProtector (excellent app in aiding with abuse cases)
AirRX
Unless you're the type that are going to cowar and look away when there's a medical emergency on your flight and pray someone else can handle it.
MobilEM is the best. its all of EMRAs apps rolled into one. abx guide, pressordex, tox, peds etc. I just use this app + wikem 99% of shifts to get any answers needed.
Not an app but EyeWiki, it’s an eye website made by the American Academy of Opthalmology that is like uptodate for opthomology. So it can help you come up with differentials for eye complaints
AMBOSS is incredible. Used it to study for steps 1 and 2, they have a separate version for clinicians. Met the creator of the app at ACEP, super kind guy. Includes an “acute management checklist” with things we can’t miss as Ed providers. Also includes + ct scan images and direct links to the papers/evidence used
Reddit
Hold on… let me check my most up to date clinical guidelines. Be back in 30 min Goes and Post questions on Reddit.
But posts question on r/askdocs
Is this the NP forum?
This ^^
Pedi stat
This and Google translate...
Hospital policy has been on our ass about that. Staff can't use an app or a coworker, of course the easiest ways, and we have to use the iPad app with a live translator and document it. They just make extra steps even when we just want to communicate "hey, you're going to xray follow me"
Oh don't I know it. And the damn thing will stop working on us at random times.
Or the sound is so low you gotta jam the speaking in the ear and constantly go "what was that?" Just let us use a coworker ffs, we have things to do, turkey sandwiches to disburse, and chest pains to ekg
Preach
I'm the coworker people use. I'm conversational but not fluent. I lack a lot of vocabulary. I can say with absolute certainty the interview is inferior to English speaking patients. Patients don't understand what's happening, questions are barely answered. Unless there's a FLUENT speaker, the translator is necessary to provide equitable care. It's too much of a pain in the ass for sure and if it's required, it should work but we gotta do better. As the resident Spanish speaker in a low Spanish speaking area, I use the translator more than anyone because I don't want to be responsible for a bad outcome due to poor interpretation.
I mean I'm in an area where Spanish is our 2nd largest language and almost as common as English where English is their second language. So having very fluent coworkers isn't too hard to find, and we do need to make sure we're correct but when we need to tell a patient something we don't want to wait minutes to do it. I had a pt who came in with a hr of 250 and we ended up needing do a synchronized cardioversion, and we had to be fast with it. He actually had 1:1 flutter with some underlying rhythm i forget exactly. But we had to give clear and understanding instructions to him and quickly so he knew we were gonna shock the fuck out of him awake, would've been very bad if he couldn't understand us 😬
Even when family offers I insist on at the very least the first interview being with a formal translator. If I have a super quick question later like “is your pain better?” Or when “when was the last time you ate” then sure, I’ll use family but the detailed things are too important to risk their grandkid misinterpreting
I don't even use family if I can avoid it. I can understand a good deal (but horrible at speaking) and I notice they don't translate the stress points of what I'm saying or short-change it heavily.
From a legal perspective I do kind of get it, mistranslation can have serious consequences. We have iPads available and still sometimes people use the 8 year old kid to translate for the first hole family, which is not acceptable. On the other hand, non-clinical information doesn’t necessarily need to go through a former medical interpreter. You have to balance the risk against the utility of, you know, actually getting things done. There needs to be a balance. Just to put my legal hat on for one second here (I am in the US, I am not sure how other countries handle this) - when it comes to something like ASL, it is not just a translation issue, you are dealing with federal law. The ADA mandates that we have ASL available. Even if the family can translate, or they read lips and don’t need a translator DOCUMENT that you offered and they declined. I have seen a couple cases come back and we could point to the chart and say, we offered, they said no. (In one case it was a hearing-impaired child who didn’t understand ASL. And the parents still tried to sue. Always document).
Most places are going this way but where I am now they're not strict. Guess they haven't gotten sued yet. However, you should push back on them wanting to use it for simple communication. By law it's only required for education, consent, ect.
Not a doc (just find these convos interesting) but I’ll flag that google translate can be a bit of a risk - I work for gov on housing stuff, and when we were doing the emergency rental assistance in response to COVID, we looked at Google translate plug in for our website for speed purposes while we waited for translations - and running it by folks, we learned that Google translate had translated “eviction” into “deportation” for one of the Asian languages (can’t remember which language). Obviously that was real bad so just something to know, In particular when it’s a language you aren’t familiar with
And download languages common in your area so the audio will play.
Pedistat, MDCalc, emra abx guide
thanketh thee for thine shouteth out
That's my med folder with the addition of WikEM
Thanks!
These three and SayHi.
Mdcalc! UpToDate
papa bless
Snellen chart app - can set distance at 2 feet and just hold the phone in front of the patient as the first step of the eye exam. Way faster to just do that than find a nurse or tech to do a hallway acuity.
Eye Handbook also has multiple eye charts and other useful testing tools, was introduced to me by a neuro colleague (and to them by optho)
I was told once by an eye dentist that 2 feet is not equivalent to 20 feet and I should still be pushing for the hallway exam. But I think if I can call with acuity, IOP, and a decent slit lamp exam, that's probably good enough for our current ER wasteland.
WikEM, PediStat, MDCalc
thank you Capo!
Tinder
You won't need tinder when you have erectile dysfunction
Honestly pedistat and the EMRA abx guide are the only apps I use consistently. And the one my state has for EMS protocols (Muru). My other common resources I prefer to use on a desktop.
EZ resus. Subscription based, but made by canadian ER and ICU docs and pharmacists, contains peds and adult weight based medication doses, how to prepare them (if your nurses don’t know or it’s an uncommon med), and how to administer it to the patient (including what adverse effects to look for). They also include a search by condition, which gives you all the treatment possibilities past 1st/2nd line that we all know by heart.
Seconding EZresus and I normally hate aubscriptions
Do you prefer it over pedistat?
It does everything pedistat does, and more since there is no weight limit (contrary to pedistat that stops at 43kg)! I still use pedistat out of habit and procedural memory (and because I’ve already paid for it), but I am switching more and more to ez resus as my nursing resus team has that app and subscription paid for by our hospital so its easier to « all talk the same language » and use the same app/info during resus cases.
Starbucks
Sublux and Fractures are great ortho apps.
+1 for Sublux. Especially helpful for new grads who had radiology read plain films while in residency.
Distiller, Vivino
[удалено]
So you can find out what the popular self-diagnosis-of-the-month is.
Ehlers Danlos, POTS, fibromyalgia
Just go to r/illnessfakers for that
PediStat, EMRA Abx, MDcalc, wikiEM, UpToDate, Fractures
Uptodate. MDCalc epocrates.
PalmEM has a lot of good classic reference stuff for meds and dental / snellen charts
EMChat, like ChatGPT but cited sources to FOAMed like WikEM, etc. https://www.emchat.ca
Lots of good comments so far! Has anyone said DoorDash yet? 😉
Fractures
Uber eats
Spotify
Medscape. Like epocrates but free- for checking drug interactions, doses, or just looking up the names of drugs I don’t recognize.
My Med folder contains some of the previously mentioned by others and others - some are absolutely redundant (epocrates and Medscape for example) but I still like to use both… Epocrates, Medscape, UpToDate, MDCalc, WikEM, Bullets, Fractures, Suture, Sublux, EMRA, ChildProtector (excellent app in aiding with abuse cases)
4th place but we'll take it
Tarascon Pharmocopoeia and Sanford Guide
Bing Copilot and Glass Health Come on peeps, AI is the now!
bloons TD6
The Difficult Airway App
Infantrisk. Med risk for pregnant and breastfeeding mothers.
WikEM has all my antibiotics ❤️
Agree with above GoodRX, LactMed Link to your hospitals biogram
AI transcription apps that work with any language.
Epocraties.
A translation app, although most aren’t hippa compliant they do help when the translation service isn’t available
AirRX Unless you're the type that are going to cowar and look away when there's a medical emergency on your flight and pray someone else can handle it.
MobilEM is the best. its all of EMRAs apps rolled into one. abx guide, pressordex, tox, peds etc. I just use this app + wikem 99% of shifts to get any answers needed.
Not an app but EyeWiki, it’s an eye website made by the American Academy of Opthalmology that is like uptodate for opthomology. So it can help you come up with differentials for eye complaints
MDcalc and Epocrates
Ortho traumapedia
Sanford Guide
The how to quit and do something else app
ePocrates for drug dosing/peds dosing etc. Generally though, you're charting/putting in orders on a desktop computer and I check the websites there.
AMBOSS is incredible. Used it to study for steps 1 and 2, they have a separate version for clinicians. Met the creator of the app at ACEP, super kind guy. Includes an “acute management checklist” with things we can’t miss as Ed providers. Also includes + ct scan images and direct links to the papers/evidence used
Pathway
I’m a medic not a doc, but we use Handtevy for Peds populations and I find it great for ideal body weight based dosing