Students prescribing emergency drug infusions utilising smartphones outperform consultants using BNFCs

Abstract

Objective: To compare the use of a drugs calculator on a smartphone with use of the British National Formulary for Children (BNFC) for accuracy, speed and confidence of prescribing in a simulated paediatric emergency.

Design: 28 doctors and 7 medical students in a paediatric department of a District General Hospital, were asked to prescribe both a dopamine infusion and an adrenaline infusion for a hypotensive child. For one calculation they used the BNFC as their reference source and for the other they used the 'PICU Calculator' on the iPhone.

Results: The drugs calculator on the smartphone was more accurate than the BNFC, with 28.6% of participants being able to correctly prescribe an inotropic infusion using the BNFC and 100% of participants being able to do so using the drugs calculator on the smartphone (p<0.001). The smartphone calculator was 376% quicker than the BNFC with the mean time saved being 5 min and 17s per participant (p<0.001). Participants were more confident in their prescription when using the drugs calculator on the smartphone with a mean confidence score of 8.5/10 compared with 3.5/10 when using the BNFC (p<0.001).

Conclusions: Utilising the smartphone was significantly more accurate and faster, with prescribers more confident in their calculations, than use of the BNFC. This applied irrespective of clinical experience with medical students utilising the smartphone technology outperforming Consultant Paediatricians when they used the BNFC.