Contributions of mobile applications to pre-hospital care: integrative review

Integrative literature review study; the databases used were the following: Scopus, Web of Science, CINAHL, SciELO, Embase, Lilacs, BDENF, Medline/PubMed, Brazilian Digital Library of Theses and Dissertations, and ProQuest Dissertations & Theses Global; (period 2017-2022), including all article categories (with abstract and full texts available with free access) in Portuguese, English, or Spanish, containing the keywords “Pre-Hospital Assistance”, “Pre-Hospital Care”, “Pre-Hospital Services”, “Pre-Hospital Emergency Care”, “Nursing”, “Mobile applications”, “Portable Software Applications”, and “Mobile Apps” in titles and/or abstracts. Two researchers applied the eligibility criteria of the studies and collected data using a previously prepared instrument.

Results

From a total of 944 studies, seven were selected for evaluation. Mobile applications developed for the pre-hospital care area are technological tools that have contributed to triage, pediatric first aid, patient safety, preparation of medications during cardiac arrest, quality of cardiopulmonary resuscitation, and communication between the emergency team and the electronic nursing record.

Conclusions

The studies highlighted the potential related to the use of mobile applications in pre-hospital care, contributing especially to improving patient safety and the quality of care provided in pre-hospital urgency and emergencies. The optimization of assistance and early diagnosis times was also shown as a contribution of applications to assistance, in addition to alerting to details that may be unnoticed.

Mobile applications; Emergency medical services; Emergency nursing; Nursing informatics; Information technology management

Database and access points	Search strategy
Scopus Access via the CAPES Periodicals Portal (http://periodicos.capes.gov.br/), using the option “Collection” > “List of bases”.	(“Technological Development” OR “Advances in Technology” OR “Development of Technologies” OR “Technological Advancement” OR “Technological Advancements” OR “Mobile Applications” OR “Mobile App” OR “Mobile Application” OR “Mobile Apps” OR “Portable Electronic App” OR “Portable Electronic Application” OR “Portable Electronic Applications” OR “Portable Electronic Apps” OR “Portable Software App” OR “Portable Software Application” OR “Portable Software Applications” OR “Portable Software Apps”) AND (“Prehospital Care” OR “Pre-Hospital Care” OR “Prehospital Services” OR “Pre-Hospital Services” OR “Emergency Medical Services” OR “Emergency Care” OR “Emergency Health Service” OR “Emergency Health Services” OR “Emergency Medical Service” OR “Emergicenter” OR “Emergicenters” OR “Medical Emergency Service” OR “Medical Emergency Services” OR “Prehospital Emergency Care”) AND (“Nursing Care” OR “Nursing” OR “Nursings” OR “Nurses” OR “Nurse”)
Web of Science Access via the CAPES Periodicals Portal (http://periodicos.capes.gov.br/), using the option “Collection” > “List of bases”.	(“Technological Development” OR “Advances in Technology” OR “Development of Technologies” OR “Technological Advancement” OR “Technological Advancements” OR “Mobile Applications” OR “Mobile App” OR “Mobile Application” OR “Mobile Apps” OR “Portable Electronic App” OR “Portable Electronic Application” OR “Portable Electronic Applications” OR “Portable Electronic Apps” OR “Portable Software App” OR “Portable Software Application” OR “Portable Software Applications” OR “Portable Software Apps”) AND (“Prehospital Care” OR “Pre-Hospital Care” OR “Prehospital Services” OR “Pre-Hospital Services” OR “Emergency Medical Services” OR “Emergency Care” OR “Emergency Health Service” OR “Emergency Health Services” OR “Emergency Medical Service” OR “Emergicenter” OR “Emergicenters” OR “Medical Emergency Service” OR “Medical Emergency Services” OR “Prehospital Emergency Care”) AND (“Nursing Care” OR “Nursing” OR “Nursings” OR “Nurses” OR “Nurse”)
CINAHL Access via the CAPES Periodicals Portal (http://periodicos.capes.gov.br/), using the option “Collection” > “List of bases”	(“Technological Development” OR “Advances in Technology” OR “Development of Technologies” OR “Technological Advancement” OR “Technological Advancements” OR “Mobile Applications” OR “Mobile App” OR “Mobile Application” OR “Mobile Apps” OR “Portable Electronic App” OR “Portable Electronic Application” OR “Portable Electronic Applications” OR “Portable Electronic Apps” OR “Portable Software App” OR “Portable Software Application” OR “Portable Software Applications” OR “Portable Software Apps”) AND (“Prehospital Care” OR “Pre-Hospital Care” OR “Prehospital Services” OR “Pre-Hospital Services” OR “Emergency Medical Services” OR “Emergency Care” OR “Emergency Health Service” OR “Emergency Health Services” OR “Emergency Medical Service” OR “Emergicenter” OR “Emergicenters” OR “Medical Emergency Service” OR “Medical Emergency Services” OR “Prehospital Emergency Care”) AND (“Nursing Care” OR “Nursing” OR “Nursings” OR “Nurses” OR “Nurse”)
SciELO Access: https://www.scielo.org/	(“Technological Development” OR “Advances in Technology” OR “Development of Technologies” OR “Technological Advancement” OR “Technological Advancements” OR “Mobile Applications” OR “Mobile App” OR “Mobile Application” OR “Mobile Apps” OR “Portable Electronic App” OR “Portable Electronic Application” OR “Portable Electronic Applications” OR “Portable Electronic Apps” OR “Portable Software App” OR “Portable Software Application” OR “Portable Software Applications” OR “Portable Software Apps” OR “Desenvolvimento tecnológico” OR “Desenvolvimento de tecnologias” OR “Avanço Tecnológico” OR “Avanços Tecnológicos” OR “Aplicativos Móveis” OR “Aplicativos Eletrônicos Portáteis” OR “Aplicativos em Dispositivos Móveis” OR “Aplicativos para Dispositivos Móveis” OR “Aplicativos de Software Portáteis” OR “Apps Móveis” OR “Desarrollo Tecnológico” OR “Adelanto Tecnológico” OR “Adelantos Tecnológicos” OR “Avances Tecnológicos” OR “Desarrollo de Tecnologias” OR “Aplicaciones Móviles”) AND (“Prehospital Care” OR “Pre-Hospital Care” OR “Prehospital Services” OR “Pre-Hospital Services” OR “Emergency Medical Services” OR “Emergency Care” OR “Emergency Health Service” OR “Emergency Health Services” OR “Emergency Medical Service” OR “Emergicenter” OR “Emergicenters” OR “Medical Emergency Service” OR “Medical Emergency Services” OR “Prehospital Emergency Care” OR “Assistência Pré-Hospitalar” OR “Serviços Pré-Hospitalares” OR “Serviços Médicos de Emergência” OR “Atendimento Pré-Hospitalar” OR “Atendimento de Emergência Pré-Hospitalar” OR “Centros de Emergência” OR “Pronto-Socorro” OR “SAMU” OR “Serviços de Saúde de Emergência” OR “Atención Prehospitalaria” OR “Servicios Prehospitalarios” OR “Asistencia de Urgencias” OR “Atención Prehospitalaria de Urgencias” OR “Atención de Emergencia Prehospitalaria” OR “Atención de Emergencias Prehospitalarias” OR “Atención de Urgencia Prehospitalaria” OR “Atención de Urgencias Prehospitalarias” OR “Atención en Urgencias” OR “Centro de Urgencia” OR “Centro de Urgencias” OR “Centros de Urgencia” OR “Centros de Urgencias” OR “Servicios de Atención de Urgencia” OR “Servicios de Atención de Urgencias” OR “Servicios de Salud de Urgencia”) AND (“Nursing Care” OR “Nursing” OR “Nursings” OR “Nurses” OR “Nurse” OR “Cuidados de Enfermagem” OR “Enfermagem” OR enfermeir* OR “Atención de Enfermería” OR “enfermeria” OR enfermer*)
EMBASE Access via the CAPES Periodicals Portal (http://periodicos.capes.gov.br/), using the option “Collection” > “List of bases”.	(“Technological Development” OR “Advances in Technology” OR “Development of Technologies” OR “Technological Advancement” OR “Technological Advancements” OR “Mobile Applications” OR “Mobile App” OR “Mobile Application” OR “Mobile Apps” OR “Portable Electronic App” OR “Portable Electronic Application” OR “Portable Electronic Applications” OR “Portable Electronic Apps” OR “Portable Software App” OR “Portable Software Application” OR “Portable Software Applications” OR “Portable Software Apps”) AND (“Prehospital Care” OR “Pre-Hospital Care” OR “Prehospital Services” OR “Pre-Hospital Services” OR “Emergency Medical Services” OR “Emergency Care” OR “Emergency Health Service” OR “Emergency Health Services” OR “Emergency Medical Service” OR “Emergicenter” OR “Emergicenters” OR “Medical Emergency Service” OR “Medical Emergency Services” OR “Prehospital Emergency Care”) AND (“Nursing Care” OR “Nursing” OR “Nursings” OR “Nurses” OR “Nurse”)
LILACS/BDENF Access: http://bvsalud.org/	(“Technological Development” OR “Advances in Technology” OR “Development of Technologies” OR “Technological Advancement” OR “Technological Advancements” OR “Mobile Applications” OR “Mobile App” OR “Mobile Application” OR “Mobile Apps” OR “Portable Electronic App” OR “Portable Electronic Application” OR “Portable Electronic Applications” OR “Portable Electronic Apps” OR “Portable Software App” OR “Portable Software Application” OR “Portable Software Applications” OR “Portable Software Apps” OR “Desenvolvimento tecnológico” OR “Desenvolvimento de tecnologias” OR “Avanço Tecnológico” OR “Avanços Tecnológicos” OR “Aplicativos Móveis” OR “Aplicativos Eletrônicos Portáteis” OR “Aplicativos em Dispositivos Móveis” OR “Aplicativos para Dispositivos Móveis” OR “Aplicativos de Software Portáteis” OR “Apps Móveis” OR “Desarrollo Tecnológico” OR “Adelanto Tecnológico” OR “Adelantos Tecnológicos” OR “Avances Tecnológicos” OR “Desarrollo de Tecnologias” OR “Aplicaciones Móviles”) AND (“Prehospital Care” OR “Pre-Hospital Care” OR “Prehospital Services” OR “Pre-Hospital Services” OR “Emergency Medical Services” OR “Emergency Care” OR “Emergency Health Service” OR “Emergency Health Services” OR “Emergency Medical Service” OR “Emergicenter” OR “Emergicenters” OR “Medical Emergency Service” OR “Medical Emergency Services” OR “Prehospital Emergency Care” OR “Assistência Pré-Hospitalar” OR “Serviços Pré-Hospitalares” OR “Serviços Médicos de Emergência” OR “Atendimento Pré-Hospitalar” OR “Atendimento de Emergência Pré-Hospitalar” OR “Centros de Emergência” OR “Pronto-Socorro” OR “SAMU” OR “Serviços de Saúde de Emergência” OR “Atención Prehospitalaria” OR “Servicios Prehospitalarios” OR “Asistencia de Urgencias” OR “Atención Prehospitalaria de Urgencias” OR “Atención de Emergencia Prehospitalaria” OR “Atención de Emergencias Prehospitalarias” OR “Atención de Urgencia Prehospitalaria” OR “Atención de Urgencias Prehospitalarias” OR “Atención en Urgencias” OR “Centro de Urgencia” OR “Centro de Urgencias” OR “Centros de Urgencia” OR “Centros de Urgencias” OR “Servicios de Atención de Urgencia” OR “Servicios de Atención de Urgencias” OR “Servicios de Salud de Urgencia”) AND (“Nursing Care” OR “Nursing” OR “Nursings” OR “Nurses” OR “Nurse” OR “Cuidados de Enfermagem” OR “Enfermagem” OR enfermeir* OR “Atención de Enfermería” OR “enfermeria” OR enfermer*)
MEDLINE/Pubmed	(“Technological Development” OR “Advances in Technology” OR “Development of Technologies” OR “Technological Advancement” OR “Technological Advancements” OR “Mobile Applications”[Mesh] OR “Mobile Applications” OR “Mobile App” OR “Mobile Application” OR “Mobile Apps” OR “Portable Electronic App” OR “Portable Electronic Application” OR “Portable Electronic Applications” OR “Portable Electronic Apps” OR “Portable Software App” OR “Portable Software Application” OR “Portable Software Applications” OR “Portable Software Apps”) AND (“Prehospital Care” OR “Pre-Hospital Care” OR “Prehospital Services” OR “Pre-Hospital Services” OR “Emergency Medical Services”[Mesh] OR “Emergency Medical Services” OR “Emergency Care” OR “Emergency Health Service” OR “Emergency Health Services” OR “Emergency Medical Service” OR “Emergicenter” OR “Emergicenters” OR “Medical Emergency Service” OR “Medical Emergency Services” OR “Prehospital Emergency Care”) AND (“Nursing Care”[Mesh] OR “Nursing Care” OR “Nursing”[Mesh] OR “Nursing” OR “Nursings” OR “Nurses”[Mesh] OR “Nurses” OR “Nurse”)
Brazilian Digital Library of Theses and Dissertations (BDTD) Access: http://bdtd.ibict.br/vufind/	(“Technological Development” OR “Advances in Technology” OR “Development of Technologies” OR “Technological Advancement” OR “Technological Advancements” OR “Mobile Applications” OR “Mobile App” OR “Mobile Application” OR “Mobile Apps” OR “Portable Electronic App” OR “Portable Electronic Application” OR “Portable Electronic Applications” OR “Portable Electronic Apps” OR “Portable Software App” OR “Portable Software Application” OR “Portable Software Applications” OR “Portable Software Apps” OR “Desenvolvimento tecnológico” OR “Desenvolvimento de tecnologias” OR “Avanço Tecnológico” OR “Avanços Tecnológicos” OR “Aplicativos Móveis” OR “Aplicativos Eletrônicos Portáteis” OR “Aplicativos em Dispositivos Móveis” OR “Aplicativos para Dispositivos Móveis” OR “Aplicativos de Software Portáteis” OR “Apps Móveis”) AND (“Prehospital Care” OR “Pre-Hospital Care” OR “Prehospital Services” OR “Pre-Hospital Services” OR “Emergency Medical Services” OR “Emergency Care” OR “Emergency Health Service” OR “Emergency Health Services” OR “Emergency Medical Service” OR “Emergicenter” OR “Emergicenters” OR “Medical Emergency Service” OR “Medical Emergency Services” OR “Prehospital Emergency Care” OR “Assistência Pré-Hospitalar” OR “Serviços Pré-Hospitalares” OR “Serviços Médicos de Emergência” OR “Atendimento Pré-Hospitalar” OR “Atendimento de Emergência Pré-Hospitalar” OR “Centros de Emergência” OR “Pronto-Socorro” OR “SAMU” OR “Serviços de Saúde de Emergência”) AND (“Nursing Care” OR “Nursing” OR “Nursings” OR “Nurses” OR “Nurse” OR “Cuidados de Enfermagem” OR “Enfermagem” OR enfermeir*)
ProQuest Dissertations & Theses Global (PQDT Global) Restricted/paid access database. Access via the BU/UFSC Portal: http://bases.bu.ufsc.br/proquest/	(“Technological Development” OR “Advances in Technology” OR “Development of Technologies” OR “Technological Advancement” OR “Technological Advancements” OR “Mobile Applications” OR “Mobile App” OR “Mobile Application” OR “Mobile Apps” OR “Portable Electronic App” OR “Portable Electronic Application” OR “Portable Electronic Applications” OR “Portable Electronic Apps” OR “Portable Software App” OR “Portable Software Application” OR “Portable Software Applications” OR “Portable Software Apps”) AND (“Prehospital Care” OR “Pre-Hospital Care” OR “Prehospital Services” OR “Pre-Hospital Services” OR “Emergency Medical Services” OR “Emergency Care” OR “Emergency Health Service” OR “Emergency Health Services” OR “Emergency Medical Service” OR “Emergicenter” OR “Emergicenters” OR “Medical Emergency Service” OR “Medical Emergency Services” OR “Prehospital Emergency Care”) AND (“Nursing Care” OR “Nursing” OR “Nursings” OR “Nurses” OR “Nurse”)

Authors, years, and countries	Names of apps and operating systems	Objectives	Focus and/or Thematic Areas	Main scientific contributions
Eksert S et al;⁽²²⁾ 2017; Türkiye	WhatsApp^® Android^® e iOS^®	To investigate the effectiveness of the WhatsApp^® smartphone application as a communication tool for the emergency team of a level-I trauma center.	Patient safety: effective communication	It reduces emergency team response time to patients who have suffered combat injuries, assists in coordinating the emergency team, reduces the team leader’s workload, and encourages the professionals involved. It is also a useful and effective communication tool for transmitting medical information between healthcare professionals due to its ease of use and fast and efficient features.
Martins W;⁽²³⁾ 2017; Brazil	SAMUV Android^®	To develop a mobile application about accidents with multiple victims to assist in the ongoing education of professionals who work in SAMU	Educational	It helps in teaching and improving content related to PHC, contributes to the learning process about multiple-victim accidents (AMUV), and supports AMUV care. It is also a tool to help as a complementary device in the continuous training and/or permanent education of SAMU professionals.
Weissheimer AS;⁽²⁴⁾ 2018; Brazil	SOS KIDS Android^®	To analyze scientific production on unintentional pediatric injuries in the home environment and describe the development and validation processes of an application for mobile devices on first aid for unintentional pediatric injuries.	Educational	It helps healthcare professionals search for updated pediatric first aid content; contributes to reducing mortality indicators and makes a technological tool of health education available to the general population; helps SAMU professionals, indicating step-by-step procedures for better understanding in addition to verbal guidance to the rescuer; makes it easier to activate the SAMU 192 with an easy-to-access button that directs to any connection screen; and reduces pediatric death rates and/or prolonged hospitalization.
LU, TC;⁽²⁵⁾ 2019; USA	(Unnamed) Android Wear^®	To develop a new app with a smartwatch worn on the wrist of first responders to facilitate high-quality cardiopulmonary resuscitation (CPR) in emergencies.	Technical skill	It significantly improves the quality of CPR related to the depth and pace of chest compressions (using the smartwatch app with real-time instructions and feedback).
Sutham K, Khuwuthyakorn P, Thinnukool O;⁽²⁶⁾ 2020; Thailand	Triagist Android^® e iOS^®	To develop a mobile application to optimize the pre-hospital patient triage process based on the CBD (Criteria Based Dispatch) triage protocol to improve emergency service requests.	Educational	It supports the pre-hospital process by classifying patients’ conditions before admission to the emergency department. It also supports the correctness of the screening protocol, screening reliability, usability, and satisfaction to users, bringing benefits such as speed and effectiveness for emergencies. It is especially suitable for non-emergency medical personnel in new emergency team training and patients who want to identify their symptoms before requesting medical services, as well as a tool to avoid overcrowding in emergency care units (in Thailand hospitals).
Pizzolato AC, Sarquis LMM, Danski, MTR;⁽²⁷⁾ 2021; Brazil	Nursing APHMóvel iOS^®	To develop an application for a mobile device for registration in the Nursing Process by nurses from the Mobile Emergency Care Service.	Nursing Process	It supports the nurses’ work by allowing the stages of the nursing process to be recorded; provides indicators for service management; and contributes to the communication and continuity of care initiated in mobile PHC.
Siebert JN et al;⁽²⁸⁾ 2021; Switzerland	PedAMINES Android^® e iOS^®	To evaluate the effectiveness of an evidence-based mobile application to reduce the occurrence of medication errors compared to conventional methods of preparation during simulated pre-hospital pediatric cardiac arrest scenarios.	Technical skill Patient safety: harm associated with medication	Decrease in the number of medication errors (in absolute terms) of the mean times of medication preparation and emergency drug administration in a pre-hospital environment. The app contributes to the objectives of the 3^rd Global Patient Safety Challenge of the World Health Organization (WHO), mainly to reduce the harm associated with medicines by 50% in all countries in the next 5 years.

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[1] Corresponding author: Daniela Couto Carvalho Barra Email: daniela.barra@ufsc.br