Using PDA's in practice.

Hey, Not an NP but I have had a PDAs of one kind or another for sometime. I was really excited to see that you can compliment your practice with them. The one thing I can say about MOST PDAs is that in the last few years... pretty much all of them have gotten up to speed. Before that, I had heard HPs crashed more... or Sonys were more reliable. I use a Sony Clie and haven't had any problems. It uses PALM OS software which pretty much anything that they make for PDAs can run on. Good Luck... hey hows the job market for NPs in the lone star?

I'm not an NP YET but I am also interested in this topic. I have a Palm 505 and I find it very useful. I plan on upgrading to another Palm before starting grad school this fall. I also use epocrates and I have a lot of reference ifo from the AACN.

Most of the docs and CRNA's where I work have the Sony Clie. I have compared both and I really refer the Palm. I guess it's just what you like.

I am an ER RN, ACNP student and co-worker proclaimed Palm Geek.

I have been using Palms for 5 years now and currently carry a Palm Tungsten C. Has 64mb memory, brilliant high resolution color screen and expansion card capability. It also has WI-FI (wireless) which is of no help to me at work as we have no wireless system. Why do I have it? It was a gift.

Anyway, if I was going out to but a new Palm today I would probably get the Palm Tungsten E. Same great color screen as the C, 32mb memory and expansion card capable. Plus it is the same size as the classic Palm V and 5xx series, best PDA's ever made! (IMHO)

I use my Palm many times per day in the ER and elsewhere. There are great Palm based medical and nursing software titles out there. I have included a list below of what I carry on mine. Note that this is not quite the full list :) .

Please feel free to Private Message me if you want more info. I have given a nationwide web seminar for Palm on how an ER nurse uses a Palm in their practice as well a snumerous local and regional presentations to nursing groups.

Andrew B

Skyscape (http://www.skyscape.com)

5 Minute Clinical Consult 2004

5 Minute Cardiology Consult

5 Minute Emergency Consult

5 Minute Pediatric Consult

5 Minute Toxicology Consult

iFacts

Handbook of Fractures

Harriet Lane

Taber's medical Dictionary

.911 (Free application that covers SARS, MOnkeypox and bioterrorism)

ARTbeat (Free application with CDC and MedWatch updates)

LAB 2003

Unbound Medicine (http://www.unboundmedicine.com)

5 Minute Clinical Consult

Unbound Surgery

CogniQ Pediatrics with Journal Abstracts and Medline search

Pocket Guide to Diagnostic Tests

Medical Wizards (http://www.medicalwizards.com)

ER Suite (Many calculators including ACLS/PALS/Infusions/Fluids (peds and burn also)/OTC dosing and more)

Ultimate Drug Guide (built in calculators for infusions)

Tarascon Pediatric Emergencies Pocketbook

Bones (Bone anatomy diagrams)

Netter (Plan is to have entire body of Netter drawings)

StatCoder (http://www.statcoder.com) All of these are FREE

Cholesterol Guide (Recommendations based on current cholesterol levels/data)

GRACE Risk Calculator (Risk of death from AMI/ACS)

AiFib Stroke Risk

Cardiac Clearance for surgery

Growth Charts (Is the child at right weight/height for age??)

JNC7 (latest hypertension guidelines)

The rest of this list is the majority of my 3rd party software grouped by category on my Palm. MOst of the items below, unless otherwise indicated, can be found at http://www.palmgear.com:

Calculators

ICU Math (Many biologic function calculators)

MedCalc (Many calculators for medicine, list is below)(FREE)

Absolute neutrophil count

Age calculator

Alveolo-arterial O2 gradient

Anion gap (plasma and urine)

Apgar score

Bayes theorem ( post-test probability given odds ratio AND sens/spec )

Body mass index

Calcium/Creatinine

Change in plasma Na

Coronary heart disease risk

Corrected calcium ( albumin et proteins )

Corrected phenytoin (albumin)

Corrected QT

Corrected sodium ( glucose, proteins and lipids )

Child-Pugh classification

Creatinine clearance ( measured, Cockroft, Schwartz )

Cardiac output ( Fick )

Dose calculator

Estimated allowable blood loss

Fractional excretion of sodium

Fluid replacement after burns (Parkland)

Glasgow coma scale

Glomerular filtration rate (Levey)

Gorlin formula ( valve area )

Growth velocity

Harris Benedict Equation for Basal Energy Expenditure

Henderson-Hasselbalch equation

Heart rate (EKG)

Hepatitis discriminant function (Maddrey score)

Ideal body weight

Infusion management (including rule of six)

Interval calculator

Iron deficit

Kt/V (URR)

IV drip rate

LDL cholesterol

Likelihood ratios

Mean arterial pressure

MELD score

Microalbuminuria

Number needed to treat

Osmotic gap (plasma and stool)

Oxygen index

Oxygen transport parameters

Postanesthetic score of Aldrete

Pediatric maintenance IV fluids

Pediatric trauma score

PIF ratio

Plasma volume

Pregnancy calculator

Proteinuria

Predicted peak flow

Ranson's score

Red blood cell indices (MCV, MCH, MCHC)

Reticulocyte index

Revised trauma score

Spirometric values

Steroid equivalence

Total body surface

Transtubular K gradient

Tubular phosphate reabsorption

Units conversion (chemistries, energy, length, pressure, temperature, volume, weight)

Urinary excretion of calcium

Urine output

Vascular resistances

Water deficit

Winters' formula (expected pCO2 in metabolic acidosis)

MedRules (FREE)

Acute Sinusitis

Alcoholic Liver Disease

APACHE II Score

Appendicitis Score

Bishop Score

Bleeding Risk Prediction

Breast Cancer Risk (Gail)

Cardiac Arrest Outcome

Cervical Radiography

Child's Classification

Community-acquired Pneumonia

Coronary Disease Probability

Coronary Disease Risk

Croup Score

CT in Minor Head Injury

DVT Probability

Ectopic Pregnancy

Family Practice Incidence Rates

GI Bleed Mortality

In-Hospital Cardiac Arrest

Mangled Extremity Score

MI Criteria in Chest Pain w/LBBB

Ottawa Ankle Rules

Ottawa Foot Rules

Ottawa Knee Rules

Pediatric Trauma Score

Pharyngitis Evaluation

Predicting Pulmonary Embolism

Pre-Op Cardiac Risk (Detsky)

Pre-Op Cardiac Risk (Goldman)

Pre-Op Cardiac Risk (Lee)

Ranson's Criteria

Renal Artery Stenosis

Revised Trauma Score

Romhilt-Estes Criteria for LVH

Strep Pharyngitis Probability

Stroke Risk in A-Fib

Successful VBAC

Trauma Score

UTI Diagnosis

Palm Hemoglobin (Calculate oxyhemoglobin dissociation curves)

Palm PEP (Post exposure prophylaxis database (needle-sticks))

PregWheel (Is she 20 weeks+? Then she goes up to OB!)

Cardiology

Predictor (Risk of Cardiogenic Shock)

TIMI Risk Calculator (http://www.timi.org) FREE

Communications

Cloak (Encrypted database for passwords and private information)

Documents To Go

JFile 5

Wordsmith (I have used this to create over 400 memos for emergency medicine practice tips and tricks)

Drugs

Johns Hopkins Antibiotic Guide (FREE with frequent updates) (http://www.hopkins-abxguide.com)

BioChem Version 1.6 (Bioterrorism guidebook, also chemical and nuclear)

ePocrates Pro (A very good drug reference guide, not well designed for nursing needs, also the paid version

comes with an infectious disease guide and holistic/alternative meds) (http://www.epocrates.com)

Infusicalc (Best drug infusion calculator I have worked with, plug in your hospital standards then just

type in dose and weight(if weight based) and BAM you have a drip rate) (http://www.aetherpalm.com)

RSI Calculator (Calculator for rapid sequence intubation drugs) (http://www.auriccanada.com)

Sanford Guide

Tarascon E-Pharmacopoeia (http://www.tarascon.com) (Another well designed drug guide, more nursing information)

Medical

Big Clock (FREE)

Code Blue (http://www.eminnovations.com/codeblue)

DxSaurus

HandBase 3 (http://www.ddhsoftware.com/handbase.html)

iSilo (http://www.isilo.com) (Document reader, I have downloaded or created a great number of iSilo readable apps,

Go to http://www.meistermed.com and choose isilo depot link. Lots of cool/FREE medical apps

Pediatrics

Riley Kidometer (http://www.kidometer.com)

Shots 2003 (Are shots up to date, how about catch up, who gets what as an adult)

Radiology

PocketRadiologist

I am in the process of deciding to purchase a PDA for use in practice. I am tired of lugging around 15 pound reference texts to each clinic, or leaving my NP prescribing guideline at home. My question is which PDA's are being used out in practice? Do any of you out there in practice use them, and if so do they save as much time as they promise? Example, does the Palm Pilot have more use than say the Sony Clie? How about memory? What about cost? Ease of use...etc,etc. I plan on downloading Epocrates and Griffith's 5 minute clinical consult, along with a couple of other prescribing references. Anyone out there have a preference to certain brands of PDA, and or software? I am in a Family Practice setting. Any response will be greatly appreciated.

The new ePocrates Pro version 6.51 has 5 Minute Consult built in, also you can choose formularies to download so you can know in advance if the insurance will cover that Rx you are wanting to write, and it has built in calculators for many, but not all, of the drugs in its database. ePocrates continues to improve their product.

Andrew B

Hey, Not an NP but I have had a PDAs of one kind or another for sometime. I was really excited to see that you can compliment your practice with them. The one thing I can say about MOST PDAs is that in the last few years... pretty much all of them have gotten up to speed. Before that, I had heard HPs crashed more... or Sonys were more reliable. I use a Sony Clie and haven't had any problems. It uses PALM OS software which pretty much anything that they make for PDAs can run on. Good Luck... hey hows the job market for NPs in the lone star?

Well I am currently not in practice, but June 1, 2004 I start fulltime with a local GP/Pain Specialist. I signed on with a regional (Central Texas) headhunter group and they put me in touch with four practices requesting NP's for employment. The other three were just about as good, but the one I signed with had a much sweeter benefit package (lot's of perks...including two weeks vacation and paid travel/hotel expenses for conferences twice a year).

I have heard that the jobs are few and far between here in Texas,but it wasn't that hard for me. I guess it depends on who you list your resume with.

not an NP, but an RN and use my sony clie every day in ER.

xo Jen

Thank you - I have used this information as well as given it to other people. It is very helpful

I have an E2 and use it so that I don't have to be "...lugging around 15 pound reference to each clinic, or leaving my NP prescribing guideline at home..." I have transcribed my pearls of practice into it, so I am good to go!