Sally Tollerfield has designed and created a free training app called My Cortisol, that helps parents give life-saving injections to children in adrenal crisis. Adrenal crisis is a significant cause of morbidity and mortality for patients who are cortisol deficient. Around 700 patients at any time are being treated for cortisol deficiency for varying diagnoses at Great Ormond Street Hospital (GOSH) alone. There are many more across the country.
The life-saving injection has to be drawn up and administered using a needle and syringe, and Sally was concerned that this was a complex task for a distressed parent faced with their very sick child. ‘Because the injection is given in an emergency, it is only ever done in a stressful situation,’ she explains.
Sally decided to develop a simple training video so that parents and carers can view the injection in real time, to either refresh themselves or guide them if needed.
Showing the process in real time was considered easiest for the parent or carer to follow. The video is silent so families can concentrate fully on the content. ‘In an emergency, there is a lot of panic and shouting,’ says Sally. ‘And it ensures the video can be used by everyone, no matter what language they speak.’
The My Cortisol app can be downloaded for free http://bit.ly/1S308qI. Sally could only use five tabs on the app, so she had to prioritise the essential information for parents and carers. The first tab is a real-time instruction video showing how to give an emergency intramuscular injection to a child using a glass vial of medication with a needle and syringe. There is a direct link at the end of the video that goes through to the emergency services number 999.
The second tab is a pictorial version of the instructions. The third tab gives instructions for the administration of glucose gel. The fourth has text boxes for parents to record medication doses and hospital contact numbers. The final tab has instructions for any receiving doctor, with details of the recommended treatment for these patients in an emergency situation.
The app was released in November 2014. Since then Sally has worked with GOSH’s clinical audit department to devise a simple satisfaction survey that parents and carers can fill out either online or on paper. Posters have been put up in the relevant clinical areas throughout the trust, and parents and carers are being shown the app in clinic and on the wards. It is also discussed during telephone contact and was presented to the parents’ support group. In addition, it has been presented at national paediatric endocrine consultant and endocrine nurse meetings.