Fitting over 400 anesthetics in your pocket...

Vargo Anesthesia teamed with a Physician Assistant and two CRNAs to create the Anesthesia Case Tips app.  This app offers the details of an impressive 400+ surgical procedures.

Editor's Rating

Editor's Rating

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Review

Per the developer’s website, the app intends to “simply explain to the anesthesia provider how we REALLY manage over 400 cases.”  The developer’s product was produced in an effort to be simple and easy to navigate while meeting the need of “providers who struggle to retrieve quick information in times of need.”  

Upon opening the app, the user is allowed a quick tour of the app’s features.  After completing or bypassing the tour, the user is able to select the surgical procedure of their liking. The procedures are offered in two different arrangements.  The user can select either the alphabetical arrangement or orthodox categorical arrangement.  Both offer good visual appeal.  If alphabetical is selected, the user is able to swipe to and then select the case for which they are seeking information.  If categorical is selected, the category is selected prior to selecting the desired surgical procedure.  After the procedure is selected, the user will typically be provided the following case information:

  • Procedure summary
  • Specific case preparation
  • Specific case concerns
  • Generally used anesthetic
  • Patient positioning
  • Duration
  • Typical EBL
  • Most common complications
  • Contraindications
  • IV Access needed
  • Pertinent notes and facts 
  • Review notes and physiology related to surgical and organ categories

While the information provided could be considered adequate to “prepare” an anesthetic, some important information was overlooked.  The lacking critical information includes: surgeon’s case perspective, preoperative patient optimization, postoperative optimization, postoperative pain control, amongst others.  

Creating a “favorites” list or adding additional notes to specific procedures are features not available.  Of note, the app does contain the nice feature of images of anatomy and physiology when case appropriate. Lastly, each case is appropriately referenced at the bottom of the page.  The references are appropriate, and sources are credible and thereby strongly add to the legitimacy of the information provided.  

Comments 

In my opinion, the gold standard for anesthesia case preparation and management is Richard Jaffe’s, Anesthesiologist’s Manual of Surgical Procedures.  The manual is the most thorough and accurate resource, containing basically everything an anesthesia provider needs to know about a specific surgical procedure.  However, you obviously cannot fit that book in your pocket.  So what is the next best thing?  Possibly the Anesthesia Case Tips app.  A major issue, as cited in the app’s description, is “surgical cases vary according to surgeon, facility, and patient.”  Therefore, this app for no reason should be considered an all-inclusive source. This app should only be considered a reference.  

The app does a nice job of appropriately mixing textbook material in with “real world” anesthetic approaches.  However, the app is a bit heavy with the creators’ opinions and “this is what we do” statements for my taste.  I suppose that is the “how we REALLY manage over 400 cases” part.   Nevertheless, Anesthesia Case Tips redeem themselves for those flaws in a number of valuable areas, such as: possible complications, superior methods of pain control, optimal emergence, and others.  While there are references provided, it is difficult to differentiate between what is truly supported by literature or text and what is opinion. 

This app would be most beneficial to SRNAs, novice CRNAs, medical students, and residents.  While there is some benefit to the seasoned anesthesia provider, there is not much offered in this app if you have experienced these case types before.  For anesthetists who are preparing to provide an anesthetic for a case they’ve yet to experience, this app optimally provides for that scenario.  The anesthetist can almost use the app as a checklist and complication “refresher.” Lastly, I am fond of the developers’ inclusion of the suggested number and gauges of venous access to the case notes. 

While I have yet to experience any performance issues, I am very disappointed with the lack of some basic components.  First, the text is extremely small.  Secondly, in an attempt to enlarge the text, I turned my phone horizontally and the app does not translate when turned horizontally.  Now, users can “double tap” and enlarge the text, but then text is often too large to fit onto the screen and one must scroll left-to-right to continue reading.  I found this to be very frustrating.  After multiple weeks of using the app, I prefer the categorical listing of surgical cases.  The alphabetical listings will scroll the case name if it is too long to fit across the vertical screen; again, this is distracting and frustrating.  Abbreviating the case name would have been a better decision.  I have yet to use this feature, but the developer offers a button that changes the app into a gray scale.  This is supposedly to ease the harshness on the eyes in low lighting situations.  I feel the price is justified, but I would try to purchase it if/when the price is lowered. 

Pros

  • wealth of procedures
  • visually appealing
  • performs well
  • images where appropriate
  • adequate references

Cons

  • lacks use in lateral position
  • small text
  • surgeons/facilities/protocols vary from information
  • no feature for notes or favorites list 

Application Specs

Date of review: 4/03/2014
Released: 1/08/2014
Platforms: Apple devices only (optimized for iPhone5)
Operating systems: iOS 6.1 or later
Version: 1.0
Seller: Matt Vargo
Price: $11.99-$14.99

 

Ken Taylor, DNP, CRNA