Aims and Objectives Emergency physicians are expected to know a little about a lot - to be the “Jack of all trades, and master of resuscitation” (Cunningham, 2021). From major trauma to urinary tract infections, practitioners need a breadth of knowledge that allows them to respond effectively to diverse crises occurring in different specialties. In our increasingly digital age this knowledge base needs to encompass the novel digital pathologies that have begun affecting patients, however at present clinician receive little training on this topic. Termed ‘biotechnological syndromes’, these illnesses occur at the intersection of human health and technology, and range from malfunctioning cochlear implants to cases of ‘medjacking’ in domestic abuse. Our research investigated the challenges that digital pathologies present in the emergency setting and defined clear recommendations for improving patient care.

Method and Design Medical professionals were recruited from three NHS sites to participate in a clinical simulation study (n=14). Simulations consisted of digital emergencies drawn from the case report literature, including illnesses from hardware issues (faults in pacemakers), software malfunctions (errors in deep brain stimulators), and technology-facilitated abuse (spyware in interpersonal violence). Qualitative and quantitative feedback was collected from participants, and extensive notes were taken by two scribes during debrief sessions. Ethics approval was obtained from University College London (UCL).

Results and Conclusion Participants struggled to identify the technology as the source of pathology and were consequently limited in the care they could provide. Challenges in management included (i) a lack of diagnostic awareness, (ii) unfamiliarity with devices, (iii) limited understanding in digital mechanisms of disease and (iv) absent treatment protocols and escalation pathways. In conclusion, despite the proliferation of digital technologies in the healthcare domain, clinicians are not trained to treat patients when these tools go wrong. Medical training urgently needs to be updated to ensure patients affected by adverse digital health events receive effective care.