Here is a real-life scenario that was described to me by an Emergency Medicine Consultant:

You are a doctor in training working the night shift in the Emergency Department. It is 4 am and you’ve been working for 10 hours straight. There are 17 patients to see and your senior colleagues are busy with a multi victim road trauma in the resuscitation room where they are desperately trying to save the lives of a young mother and her son.

In front of you is a 47-year-old man with chest pain. You know from medical school that there are many possible causes of chest pain, some life-threatening, many not. The pain sounds muscular in origin, but
you know that some heart attacks can present in this way too.

You want to be able to send this man home safely, but you know that the consequences of missing a heart attack could be disastrous – for you and the patient.

Your initial examination and tests are normal. Your dilemma – do you admit the patient for serial blood tests and electrocardiograms (ECGs) or send him home with pain killers?

Your next step is to look for a hospital or national guidelines/protocols. But in this case, the hospital guidelines are stored on the intranet and you’re not sure how to access it and don’t have time to ask. The next best alternative is to seek out another information source online, interrupt a more senior doctor or take a snap judgement. Of the alternatives, there is no clear winner. Another information source however credible may clash with hospital policy, interrupting a more senior doctor could endanger another patient and a snap judgement is exactly that.

A daunting situation for anyone to be in I think you’ll agree and that’s why we’ve developed GuideDoc. The GuideDoc platform provides easy access to critical information, so situations described above don’t happen.

Here is the likely outcome if the hospital guideline on Chest Pain was available.

By reviewing the most recent guideline on chest pain, you could have discovered that because:

  1. The pain radiates to the left arm and jaw
  2. The symptoms are exertional
  3. The initial blood tests were performed very soon after the pain
  4. The patient’s TIMI score is high

There is a significant likelihood that this pain is cardiac in origin and that you should not only admit the patient for further testing and observation but also:

  1. Prescribe heparin and anti-platelet therapy
  2. Maintain the patient on continuous cardiac monitoring
  3. Schedule a cardiology consultation and exercise stress test for the next morning
  4. Tell the patient to fast from 12 midnight for cholesterol testing the next morning

The GuideDoc team is proud to be working on a solution that helps doctors and medical professionals save lives. If you are a medical professional working in an area that could benefit from have Guidelines more readily available, please contact us about getting involved in our Beta Launch.

About the author

Seán Kirwan is the founder of GuideDoc and has been involved in web application delivery for the past 12 years. He is based in Dublin, Ireland. Follow him on Twitter @sk_ie.

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