In its two years of existence, Apple's iPhone has sold more than 21 million units. This summer's release of the iPhone 3GS should boost that total considerably. That's a lot of Americans with a lot of communications capability in their hands--and a lot of communications capability EMS could be taking greater advantage of.

To help it do that, meet smart-ICE, a first-of-its-kind iPhone app that advances the concept of ICE ("In Case of Emergency" information kept on cell phones) into the next generation.

The brainchild of a 30-year fire/EMS veteran, smart-ICE has several key functions:

• Storage of personal and medical information, including medications, allergies, past conditions, etc.
• An alert feature that sounds a PASS-type tone every two minutes after calling 9-1-1. If a caller is incapacitated, this calls the attention of responders to the iPhone and its relevant information.
• Passcode wallpaper that can contain custom messages for emergencies. An owner who locks their phone can use this feature if they’re incapacitated to direct responders to an emergency contact who can tell them the owner's passcode, allowing the responders to unlock the iPhone and access its information.
• Emergency contact dialing through a tab within the app.

"I think," says creator Tim Green, formerly an EMS director in Ohio, "it has just about everything an EMS provider could need to help treat a person."

Green conceived smart-ICE last year following a serious medical event with his wife. Good care led to a positive outcome for her, but in the moment of a loved one's near-death emergency, even a longtime EMSer like Green had trouble recalling her complete set of medical details.

"You spend 30 years in fire and EMS, and think you've seen it all," Green notes. "But it's a lot different when you're working on a member of your own family. Once I got to the ED that day, they were asking me questions like when her surgery was and what medications she was on. I'd get close, but couldn't remember everything exactly, and I realized the need for having that information available."

Green subsequently teamed with a nephew who had the needed technological expertise, and they developed the app, originally known as EMS Alert. They created a company to market it, EMS Options, and rolled it out in May.

It's a boom era for smart-phone apps, though, and EMS Alert, while more capable than many, wasn't positioned to stand out among the plethora of emergency, first aid and related apps coming available. That's what led to July's rechristening as the more self-explanatory smart-ICE. As well, EMS Options allied with a company called ICE4Safety, which promotes trademarked, internationally recognized ICE images, to create an icon that would be easily identifiable for emergency personnel checking patients' phones.

"There are recognition issues to consider--paramedics have to be able to look at something like this and know it's an ICE program," says Green. "The EMS Alert emblem we were using before didn't jump out at you and say ICE. We wanted something that could be nationally and even globally recognized, and now I think we have that."

Global recognizability is also the idea behind one of smart-ICE's most unique features, its automatic emergency tone. The alert begins when the app is used to call 9-1-1, and continues until it's manually stopped. If a caller loses consciousness before responders arrive, the familiar PASS tone alerts the responders to the presence of the phone, where they will find, and hopefully activate, the smart-ICE icon.

The benefit of ICE programs has also occasionally fallen victim to locking phones that keep providers from accessing their information. The wallpaper feature is a way around that. A user could put the name of their spouse or a close friend on the wallpaper as a reference for rescuers if the user for some reason can't unlock their phone. A crew member can then call this contact and get the code to do so in an emergency.

Right now smart-ICE is just for the iPhone, with a non-telephone version available for the iPod. Future plans call for expansion to the BlackBerry and phones on the Windows mobile platform, and ultimately beyond. Says Green: "We want to be able to give everyone the opportunity, no matter what kind of smart-phone they have, to have this type of application."

An expanded family version is also coming, which will hold profiles for up to five individuals, as well as information on things like immunizations and hospitalizations.

smart-ICE is available at the iPhone App Store; follow the link from www.ems-options.com.

Other Apps of Interest

The number of emergency, medical and other apps pertinent to EMS providers grows daily. Here are a few of note:

• Epocrates, from Epocrates, Inc.: Continually updated clinical information and decision support tools for healthcare professionals.
• Medical Resources, from Skyscape: 500 resources across three dozen medical specialties, including partnerships with top medical publishers and clinical information, drug guides and interaction analyzers.
• Five-Minute Emergency Medicine Consult, from Skyscape: A quick-reference guide covering more than 600 clinical problems created in partnership with Lippincott, Williams & Wilkins.
• Mobile Medical News, from Crossgates AC: Top medical news, now with consolidated feeds, updated every 15 minutes.
• Davis's Drug Guide, from Unbound Medicine: Information on more than 5,000 generic and brand-name drugs, including interactions and appendices with dose calculations.
• Taber's for Mobile and Web, from Unbound Medicine: A mobile version of Taber's Cyclopedic Medical Dictionary includes more than 60,000 terms, plus definitions and other resources.
• ResQr First Aid & CPR Coach, from Think Safe: Comprehensive first aid/CPR software that helps users provide assistance in various emergencies. Several components (CPR Coach, Diabetic Coach, Seizure Disorder Coach, Severe Allergy Coach) have been broken out into separate apps.
• Emergency Medical Spanish Guide, from Mavro: A tool for non-Spanish speaking healthcare professionals to ascertain vital medical information from Spanish-speaking patients.
• The Daily FEMA Insider, from Crossgates AC: A free app that tracks FEMA's releases about terror activity, homeland security, threatening weather and more.
• Citizen Connect, from Connected Bits: A city hotline for citizen complaints in Boston. Other cities are likely to follow with comparable products.
• 9-1-1 Help, from USA Links Multimedia: Fills the screen with an animated flashing 9-1-1/help message in red and white, communicating the need for assistance over long distances or through windows.