Background and Goal of Study: Medical crisis, during surgery or in a critical care environment, has two characteristics: they are at the same time potentially severe and are not usually seen. This combination of factors makes the rate of human mistake higher. Learning and management of crisis situations has not a globally accepted rule, and teaching methods such as the one used by pilots have been imported to the crisis management's field. We wanted to import from aviation industry the use of cognitive aids in a more technological and accessible way using our smartphones.

Materials and Methods: During 2015 an in-depth we conducted a review of procedures, protocols, algorithms and guides published by national and international journals and societies about management and treatment of crisis situations that could happen in an anesthesia or critical care environment. Once reviewed, we started writing algorithms that could help in those situations as a cognitive aid. At the same time, developing a suitable platform for those algorithms was necessary. Our roadmap was:
1- Contacting an app programming team
2- Meetings and brainstorming about features in the app were held: hyperlinks, dose calculator…
3 - Topic distribution, classification and priority
4 - Tests in simulation units
5 - Publication
6 - Review and updates
7 - Download numbers analysis

Results and Discussion: Our tests with our app 'Anestcritic' in simulated scenarios allowed us to improve the results in comparison to those without any cognitive help, showing a more structured differential diagnosis, with less initial mistakes to diagnose and treat, even in those less frequent pathologies. After 6 months of its publication, 'Anestcritic' has reached 849 downloads in both Android (213) and iOS (636) platforms. It has been in the top ranking of medical apps for several weeks. Only 11 of the 213 downloads in Android platforms were deleted after being downloaded, showing a high level of acceptance among users.

Conclusion(s): The unquestionable utility of protocols in crisis situations does not necessary means these cannot be improved. New technologies, and especially the widespread use of smartphones, provide us with a unique opportunity. The successful numbers of download after launching 'Anestcritic' 6 months ago, show us the high demand of cognitive helps and the awareness of its utility among anesthesiologists and critical care providers.

Creating cognitive aids for crisis situations in smartphone platforms: ‘anestcritic’ and our experience