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Creating safer decision support systems for paediatric emergency care: the Paeds ED project
  1. Haidar Samie

Abstract

Introduction Paediatric emergency care requires precision in prescribing but this can be prone to error. Traditional ‘aide memoires’ for resuscitation of ill and injured children have limitations. We identified a need to develop a clinical decision support system (CDSS) that could be more accurate and replace these more traditional approaches.

Objective To describe the development of a novel application (Paeds ED) designed to support clinicians making real time calculations in resuscitation of critically ill and injured children.

Methods The iPhone platform was chosen to develop an application that would meet the needs of emergency medicine physicians managing certain categories of ill and injured children. Key time dependent emergency conditions were identified. An iterative development cycle was used, structured to address accuracy, reliability, interactivity and rapidity of accessing key information.

Results The Paeds ED decision aid contains an age to weight converter and drug formulary list. The age to weight conversions are based on the WHO 50th percentile tables. Once the user enters the age or weight the application is able to construct a formulary list for that patient. The formulary can be accessed directly or by a modular interface which is situation specific using standard internationally recognised resuscitation algorithms. The application was launched onto the Apple store for purchase under the terms of a ‘not for profit’ basis. A total of over 16 000 downloads of the two main applications have occurred in 50 different countries worldwide in the first 10 months since launch. Reviews have rated the application as being 4+ out of 5.

Conclusions We have developed a CDSS application designed for use by staff involved in the management of critically ill and injured children. The Paeds ED application provides rapidity of accessing key information in acute situations and helps create safer working practices in emergency care.

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