Smartphones in the Wild: Can Technology Improve Emergency Care in Remote Settings?

Abstract

Environmental illness and injury in the wilderness can occur quickly and unexpectedly, requiring a swift response with limited resources. Remote locations inhibit communication and outside support, leading to extended time to definitive care. That results in greater responsibility for first responders. A mobile application with protocol for wilderness issues may help providers with limited knowledge to manage medical emergencies until professional medical care is possible. Improvement in first responder care can also decrease emergency medical services and hospital costs, in addition to preventing long-term complications. The purpose of this study is to determine, by simulated scenario performance, whether the use of a smartphone application will improve management of common medical emergencies in the wilderness. We identified the top-rated survival and first aid applications available in the iPhone and Android digital application markets. We designed 6 emergency scenarios set in a wilderness context with performance based on standard criteria outlined in Auerbach’s Wilderness Medicine textbook. Using a prospective study, we compared patient care performance between simulations that were application assisted and simulations that were not. A population of 66 simulations of 6 scenarios completed by 11 inexperienced students provided a 64% power to detect a difference of 50% in the improvement of scores when using the wilderness medicine application. Interrater reliability was also calculated on a subset of the stations. Performance on simulations did not vary with smartphone application use, according to t test (P = .296). Smartphone applications theoretically provide accessible knowledge for inexperienced first responders in remote settings. Our study suggests an opening in the smartphone application market for an effective wilderness survival tool. Furthermore, lack of training in basic first aid may not be compensated for by smartphone application help. We plan to extend this study to include more participants.