A Novel Smartphone Application to Support Learning and Maintaining Competency with Bier Blocks for Pediatric Forearm Fracture Reductions

Distal forearm fractures are among the most common injuries presenting to the Pediatric Emergency Department (PED). Bier block (BB), or intravenous regional anesthesia, is a safe and effective alternative to procedural sedation for closed reduction of forearm fractures, and is associated with fewer adverse events, a shorter length of stay and reduced costs. BB has long remained relatively underutilized, however with an increasing emphasis on efficient resource use and patient-centered care, there is renewed interest in this technique. Our tertiary PED recently became the first in Canada to successfully implement an active BB program. Subsequently, we developed a mobile BB smartphone application (App) designed to support the safe, sustained departmental use of BB. The App can be used for training and maintenance of competency, and incorporates instructional material, as well as our institutional BB protocol, printable medication order sheets and monitoring forms. The present report describes the development and functionality of the BB smartphone App. Additionally, we highlight how the App serves as a paradigm of an educational tool designed for individual users, but also to support the department-wide implementation and dissemination of a new technique. 2