On-call apps have been covered in this publication before, with reference apps taking centre stage [1]. This article will focus on apps with specific functions which can be of use in frequently arising emergency scenarios. However, for reference apps I would recommend BMJ Best Practice and Up-To-Date. Both have clear explanations and are evidence based including hyperlinked references, with the added benefit of automatically recording CPD points.
Ishihara Color Blindness Test
FREE
Android – equivalent iOS alternatives available
Size 6.49MB
This app will be important for those needing to quickly assess for red-green colour blindness such as in cases of orbital infection, concern about traumatic or post-endoscopic sinus surgery haematoma or neoplasia. Where there is doubt about preoperative colour vision, this app could aid in checking this.
Although for young pre-numerate children using objects or toys on the ward may be preferable, satisfactory examples may be hard to find in a hurry. The app offers a short (24-plate) or full (38-plate) test and documents the result in the patients records for comparison with subsequent results. This may be especially valuable to those working without on-site ophthalmology cover.
"This app will be important for those needing to quickly assess for red-green colour blindness such as in cases of orbital infection, concern about traumatic or post-endoscopic sinus surgery haematoma or neoplasia"
The app opens to a brief introduction explaining the basics of colour blindness. Once a test is selected, the user can show the phone to the patient and either the patient or clinician can input answers. On completion of the test a breakdown of normal, protanopia (red colour blindness), deuteranopia (green colour blindness) and total colour blindness, results are given. Answers to individual plates are given with an explanation of what is seen in different defects. Clinical judgement is required, and a full eye assessment should always be undertaken by an experienced clinician at the earliest opportunity.
Ishihara Color Blindness Test app.
Mobile Airway Card
FREE
Android and iOSSize 50.72MB
This app from Cincinnati Children’s Pediatric Otolaryngology is especially useful for any ENT specialist working in a paediatric centre, but could come in handy for anyone working where the accident & emergency department receives children. Its simplicity is its strength. On opening the app, the user is presented with the menu of options. Its features include diagrams of the Cotton-Myer grading scale [2]. There are tracheostomy tube, balloon, and T tube sizing charts in which the user selects parameters such as tube type e.g. Bivona neonate and tube size to receive the key measurements such as outer diameter and length.
It saves clinicians having to internet search sizing information or keep this as screenshots on their phone or printed in a wallet or work bag. Most usefully, it helps calculate percentage of airway obstruction using accepted ETT size and age which can then be clearly recorded in operation notes and discharge letters. A table of age, tube size and percentage obstruction is also included.
There is also an example of a normal airway to show patients/parents. It would be useful to include some common variations in this such as laryngomalacia to help these discussions.
Conclusion
Two apps which may be useful to any ENT clinician, working in general or sub-specialist fields, are discussed. Mobile devices are becoming an ever-more integrated part of life with a broad range related to surgery [3]. Ready access to emergency tools and information can be a worthwhile addition to surgical instruments.
Mobile Airway Card app.
References
1. Lee J. On-call ENT apps. ENT & Audiology News 2022;31(1):62-3.
2. Myer CM 3rd, O’Connor DM, Cotton RT. Proposed grading system for subglottic stenosis based on endotracheal tube sizes. Ann Otol Rhinol Laryngol 1994;103(4 Pt 1):319-23.
3. Mobasheri M, Johnston M, Syed U, et al. The uses of smartphones and tablet devices in surgery: A systematic review of the literature. Surgery 2015;158(5):1352-71.
Disclaimer: This is a review of apps that may be utilised by on-call ENT clinicians, but this does not represent an endorsement and these apps should not be considered medical devices. Like any source of information, apps can become out of date or superseded. Responsibility remains on the user to crosscheck information where relevant.
